Biological Signatures of Asymptomatic Extra- and Intracranial Atherosclerosis The Barcelona-AsIA (Asymptomatic Intracranial Atherosclerosis) Study
Por:
Lopez-Cancio, E, Galan, A, Dorado, L, Jimenez, M, Hernandez, M, Millan, M, Reverte, S, Sunol, A, Barallat, J, Massuet, A, Alzamora, MT, Davalos, A and Arenillas, JF
Publicada:
1 oct 2012
Resumen:
Background and Purpose-Intracranial atherosclerotic disease (ICAD) remains a challenge for stroke primary and secondary prevention. Molecular pathways involved in the development of ICAD from its asymptomatic stages are largely unknown. In our population-based study, we aimed to compare the risk factor and biomarker profiles associated with intracranial and extracranial asymptomatic cerebral atherosclerosis.
Methods-The Asymptomatic Intracranial Atherosclerosis (AsIA) study cohort includes a random sample population of 933 white subjects >50 years with a moderate to high vascular risk (based on REGICOR score) and without a history of stroke (64% males; mean age, 66 years). Carotid and intracranial atherosclerosis were screened by cervical and transcranial color-coded Duplex ultrasound, being moderate to severe stenoses confirmed by MR angiography. We registered clinical and anthropometric data and created a biobank with blood samples at baseline. A panel of biomarkers involved in atherothrombogenesis was determined: C-reactive protein, asymmetric-dimethylarginine, resistin, and plasminogen activator inhibitor-1. Insulin resistance was quantified by Homeostasis Model Assessment index.
Results-After multinomial regression analyses, male sex, hypertension, smoking, and alcoholic habits were independent risk factors of isolated extracranial atherosclerotic disease. Diabetes and metabolic syndrome conferred a higher risk for ICAD than for extracranial atherosclerotic disease. Moreover, metabolic syndrome and insulin resistance were independent risk factors of moderate to severe ICAD but were not risk factors of moderate to severe extracranial atherosclerotic disease. Regarding biomarkers, asymmetric-dimethylarginine was independently associated with isolated ICAD and resistin with combined ICAD-extracranial atherosclerotic disease.
Conclusions-Our findings show distinct clinical and biological profiles in subclinical ICAD and extracranial atherosclerotic disease. Insulin resistance emerged as an important molecular pathway involved in the development of ICAD from its asymptomatic stage. (Stroke. 2012;43:2712-2719.)
Filiaciones:
Lopez-Cancio, E:
Autonomous Univ Barcelona, Hosp Univ Germans Trias & Pujol, Dept Neurosci, Barcelona 08916, Spain
Galan, A:
Univ Autonoma Barcelona, Hosp Univ Germans Trias & Pujol, Dept Biochem, Barcelona 08916, Spain
:
Autonomous Univ Barcelona, Hosp Univ Germans Trias & Pujol, Dept Neurosci, Barcelona 08916, Spain
:
Autonomous Univ Barcelona, Hosp Univ Germans Trias & Pujol, Dept Neurosci, Barcelona 08916, Spain
:
Autonomous Univ Barcelona, Hosp Univ Germans Trias & Pujol, Dept Neurosci, Barcelona 08916, Spain
:
Autonomous Univ Barcelona, Hosp Univ Germans Trias & Pujol, Dept Neurosci, Barcelona 08916, Spain
Reverte, S:
Autonomous Univ Barcelona, Hosp Univ Germans Trias & Pujol, Dept Neurosci, Barcelona 08916, Spain
Sunol, A:
Autonomous Univ Barcelona, Hosp Univ Germans Trias & Pujol, Dept Neurosci, Barcelona 08916, Spain
Barallat, J:
Univ Autonoma Barcelona, Hosp Univ Germans Trias & Pujol, Dept Biochem, Barcelona 08916, Spain
Massuet, A:
Univ Autonoma Barcelona, Hosp Univ Germans Trias & Pujol, Magnet Resonance Unit, Barcelona 08916, Spain
:
ICS IDIAP Jordi Gol, Primary Healthcare Res Support Unit Metropolitana, Barcelona, Spain
:
Autonomous Univ Barcelona, Hosp Univ Germans Trias & Pujol, Dept Neurosci, Barcelona 08916, Spain
Arenillas, JF:
Hosp Clin Univ, Dept Neurol, Stroke Unit, Valladolid, Spain
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