Key result
Acute ischemic stroke patients with metabolic syndrome exhibited significantly higher arterial stiffness (PWV 12.9 vs 11.2 m/s) and immune-inflammatory markers than stroke patients without metabolic syndrome.
Cross-Sectional (n=377)
No
Absolute Event Rate: 12.9% vs 11.2%
p-value: p=<0.001
Metabolic syndrome in acute ischemic stroke patients is associated with higher levels of immune-inflammatory markers and increased arterial stiffness compared to stroke patients without metabolic syndrome.
Metabolic syndrome may exacerbate arterial stiffness and inflammation in acute ischemic stroke; hypothesis-generating and should not yet change practice.
OBJECTIVE: The aim of our study was to evaluate the associations between arterial stiffness indexes and immune-inflammatory markers in subjects with acute ischemic stroke with and without metabolic syndrome. MATERIALS/METHODS: We enrolled 130 patients with acute ischemic stroke and metabolic syndrome, 127 patients with acute ischemic stroke without metabolic syndrome and 120 control subjects without acute stroke. Applanation tonometry was used to record the augmentation index (Aix) and pulse wave velocity (PWV). We also evaluated plasma levels of C-reactive protein (CRP), Interleukin-1beta (IL-1β), tumor necrosis factor-alpha (TNF-α), Interleukin-6 (IL-6) and Interleukin-10 (IL-10), E-selectin, P-selectin, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), von Willebrand Factor (vWF) plasma levels, tissue plasminogen activator (TPA) and plasminogen activator inhibitor-1 (PAI-1). RESULTS: In subjects with acute ischemic stroke and metabolic syndrome we observed higher median plasma values of immuno-inflammatory markers. In acute ischemic stroke patients and metabolic syndrome in relation of each TOAST subtype we observed a more significant positive correlation between PWV and immuno-inflammatory markers. CONCLUSIONS: Stroke subjects with acute ischemic stroke and metabolic syndrome showed a higher degree of immuno-inflammatory and arterial stiffness indexes possibly due to metabolic background of these types of patients that trigger a more intense immune-inflammatory activation irrespective of stroke subtype, whereas being related to stroke subtype in subjects without metabolic syndrome.
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Tuttolomondo et al. (2014) conducted a cross-sectional in Acute ischemic stroke and metabolic syndrome (n=377). Metabolic syndrome vs. Acute ischemic stroke without metabolic syndrome was evaluated on Pulse wave velocity (PWV) as a measure of arterial stiffness (p=<0.001). Acute ischemic stroke patients with metabolic syndrome exhibited significantly higher arterial stiffness (PWV 12.9 vs 11.2 m/s) and immune-inflammatory markers than stroke patients without metabolic syndrome.
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