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Karger_ESC London_2013

22. European Stroke Conference 659 Acute stroke: clinical patterns and practice High PLA2 levels in acute ischemic and hemorrhagic stroke are independent of imaging and clinical severity scores D. Rosenbaum1, C. Rosso2, r Bittar3, D. Bonnefont rousselot4, p. Giral5, X. Girerd6, E. Bruckert7, C. Pires8, Y. Samson9 AP-HP, Unité de prévention cardiovasculaire, Pitié-Salpêtrière Hospital, Paris, Par-is, FRANCE1, AP-HP, Urgences Cérébro-Vasculaires, Pitié-Salpêtrière Hospital, Paris, Par-is, FRANCE2, AP-HP, Service de biochimie des lipides, Pitié-Salpêtrière Hospital, Paris, par-is, FRANCE3, AP-HP, Service de biochimie des lipides, Pitié-Salpêtrière Hospital, Paris, Paris, FRANCE4, AP-HP, Unité de prévention cardiovasculaire, Pitié-Salpêtrière Hospital, Paris, Paris, FRANCE5, AP-HP, Unité de prévention cardiovasculaire, Pitié-Salpêtrière Hospital, Paris, Par-is, FRANCE6, AP-HP, Unité de prévention cardiovasculaire, Pitié-Salpêtrière Hospital, Paris, Paris, FRANCE7, AP-HP, Urgences Cérébro-Vasculaires, Pitié-Salpêtrière Hospital, Paris, Par-is, FRANCE8, AP-HP, Urgences Cérébro-Vasculaires, Pitié-Salpêtrière Hospital, Paris, Paris, FRANCE9 Background: Lipoprotein-Phospholipase A2 (PLA2) is a circulating enzyme marker of vascular inflammation as-sociated with ischemic stroke risk in primary prevention. Little is known about PLA2 during acute stroke, especially in patients with hemorrhagic stroke (HS). Our objective was to assess PLA2 levels in a population of patients with acute ischemic (IS) and HS. Methods: Patients referred to the stroke unit with sudden onset focal deficits (<6h) were included prospectively. PLA2 was measured at admission using ELISA PLAC test and at day one and day seven in IS patients. NIHSS was rated at admission, at D1 and D7 and the modified rankin scale was noted at 3 months. All patients had a diffusion MRI at admission (<6h) and at day one to measure infarct volume. According medical history, examination and MRI results patients were categorized in 3 groups: IS, TIA, HS. Results: Our population consisted 54 patients with IS, 19 with TIA and 15 with HS. Mean age was 69 ± 17 years and 58% were males. Mean PLA2 mass was 334 ± 136 microg/L. Among our patients: 65% had hypertension, 17% diabetes, 39 % hypercholesterolemia, 23% were obese and 17% current smokers. At baseline, mean NIHSS score was 12 ± 8. IS and HS patients did not differed in terms of age, severity and risk factors distribution. PLA2 mass was significantly higher in the HS group (434 ± 188 vs. 306 ± 104 p=0.02). This differ-ence persisted after adjustment for LDL-C levels, age and hypertension presence. but was not dif-ferent between TIA and IS groups. In IS patients, PLA2 remained unchanged at D1 and D7 and was not correlated to clinical severity scores nor infarct volume. Conclusion: PLA2 mass is high in acute stroke, especially in patients with hemorrhagic stroke. In acute IS, PLA2 mass remain stable during the first week and was independent of imaging or clinical severity mark-ers. 696 © 2013 S. Karger AG, Basel Scientific Programme 660 Acute stroke: clinical patterns and practice Structure and degree of cognitive impairment in patients in acute cerebral infarction V.A. Yavorskaya1, O.B. Bondar2, I.I. Chernenko3, B.O. Bondar4 Kharkiv medical Academy of postgraduate education, Kharkiv, UKRAINA1, Kharkiv medical Academy of postgraduate education, Kharkiv, UKRAINA2, Kharkiv medical Academy of post-graduate education, Kharkiv, UKRAINA3, Kharkiv medical Academy of postgraduate education, Kharkiv, UKRAINA4 Cerebral infarction (MI) may be the sole or main cause of cognitive impairment (CP), it can also increase the Pre-Stroke control or exercise and activate current neurodegenerative process of forma-tion of the “mixing” of cognitive disorders. Objective: To identify and analyze the cognitive impairment in patients in acute MI. Material and Methods: 71 patients were examined in acute myocardial infarction at the age of 27 to 60 years (mean age 50,39 ± 0,89), of which 46 men and 25 women. The diagnosis was confirmed by MRI. The severity of the assessed scale NIHSS - from 8 to 15 points. All patients were conscious and without language disorders. The control group consisted of 20 persons vascular profile aged 29 to 67 years (mean age 49,1 ± 2,46) without acute cerebrovascular accident in the history of that age had cognitive disorders. All patients underwent general clinical research, laboratory, instrumental. Neuropsychological study included scales MMSE, battery test frontal dysfunction (BTLD), the test clock drawing. To identify the emotional and anxiety disorders conducted test Spielberg, the pres-ence and severity of depression was assessed using the Beck questionnaire. Results in Test MMSE CP (27 points or less) were found in 92.95% of the examined patients, de-cline in BTLD (less than 16 points) - in 80.28% of patients. Possible differences (p <0.001) in the general ball on a scale MMSE recorded between patients with MI and control group (23,79 ± 0,31 and 28,75 ± 0,42 respectively). Also showed a significant (p <0.001) decrease in cognitive function in middle-aged patients compared with younger (23,13 ± 0,39 - and the average age 25,65 ± 0,43 - young age). The high negative correlation between the values of MMSE and body mass index - (r = -0,9315, p <0.05). The reliability of the results (p <0.01) was demonstrated in patients with different levels of education (24,67 ± 0,58 higher and 22,87 ± 0,49 secondary education). However, the reliability of CP were found between gender of patients (p> 0.05). Conclusion: The severity of CP patients in acute MI depends on age, education level, body mass in-dex, and is independent of the article.


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