Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"Joint associations of atherogenic index of plasma and high-sensitivity C-reactive protein on stroke: a large-scale prospective cohort study","authors":"Yu-Hua Liu MD ,&nbsp;Qiong-Hui Lao MD ,&nbsp;Rong-Rui Huo MD ,&nbsp;Cui Ma MD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108450","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108450","url":null,"abstract":"<div><h3>Backgroud</h3><div>Although both the atherogenic index of plasma (AIP) and high-sensitivity C-reactive protein (hs-CRP) are recognized as risk markers for stroke, their combined effect has yet to be fully understood. To address this gap, we introduced the inflammatory atherogenic index (IAI), a composite measure incorporating AIP and hs-CRP, and investigated its potential in predicting stroke ris</div></div><div><h3>Methods</h3><div>We analyzed data from the China Health and Retirement Longitudinal Study (CHARLS). IAI was calculated using the formula: IAI = AIP × hs-CRP / 10. Cox proportional hazard models were used to estimate stroke risk associated with IAI. Mediation analysis using VanderWeele’s method evaluated the mediating role of systolic and diastolic blood pressures.</div></div><div><h3>Results</h3><div>The study included 9,687 participants with a mean baseline age of 58.66 years (SD = 9.23), of whom 4,542 (46.9%) were male. Over the 7-year follow-up period, 662 incident stroke cases (6.8%) were recorded. After adjusting for all covariates, each standard deviation (SD) increase in the inflammatory atherogenic index (IAI) was linked to an 11.0% higher stroke risk (HR = 1.11, 95% CI: 1.03–1.19). A nonlinear, inverted U-shaped relationship between IAI and stroke risk was observed (P = 0.015). Mediation analysis showed that systolic and diastolic blood pressures mediated 19.64% and 25.79% of the IAI-stroke association. Hs-CRP and AIP also interacted synergistically to increase stroke risk (synergy index = 1.35, 95% CI: 1.03–1.76).</div></div><div><h3>Conclusions</h3><div>IAI is associated with increased stroke risk, with mediation by blood pressure. This highlights the potential of IAI as a biomarker for stroke risk, with early intervention in patients with high IAI potentially reducing stroke risk.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 11","pages":"Article 108450"},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life expectancy after an ischemic stroke or transient ischemic attack in older adults - the role of frailty","authors":"Susanna R. Prins MD ,&nbsp;Birgit A. Damoiseaux-Volman PharmD, PhD ,&nbsp;Judith A. van Erkelens ,&nbsp;Sarah E. Vermeer MD, PhD ,&nbsp;Nathalie Van der Velde MD, PhD ,&nbsp;Renske M. Van den Berg-Vos MD, PhD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108448","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108448","url":null,"abstract":"<div><h3>Introduction</h3><div>Ischemic stroke and transient ischemic attack (TIA) reduce life expectancy in older adults. The impact of frailty on life expectancy following these events is unclear.</div></div><div><h3>Methods</h3><div>This nationwide retrospective cohort study used data from the Dutch health insurance claims database Vektis. We included patients aged ≥70 with ischemic stroke or TIA in 2018, selecting frail individuals using the U-PRIM frailty index. A non-frail control group was selected using frequency matching on age, sex, and socioeconomic status. Mortality data up to May 2024 provided 5.4–6.4 years of follow-up. Kaplan-Meier survival curves and Cox regression were used to estimate survival and calculate hazard ratios (HRs) for the association between frailty and mortality. As a secondary outcome, cardiovascular events were assessed.</div></div><div><h3>Results</h3><div>Among 16,778 frail and 10,069 non-frail patients, frailty was associated with higher mortality and shorter life expectancy. Mortality in frail vs. non-frail patients was 66 % vs. 55 % after ischemic stroke and 54 % vs. 36 % after TIA. Life expectancy was 3.8 vs. 5.2 years after ischemic stroke and 5.9 vs. &gt;6.4 years after TIA. Adjusted HRs for the association of frailty with mortality were 1.30 after ischemic stroke and 1.72 after TIA. Cardiovascular events were more common in frail patients: 40 % vs. 38 % after ischemic stroke and 18 % vs. 13 % after TIA.</div></div><div><h3>Conclusion</h3><div>Frailty is associated with increased long-term mortality and reduced life expectancy after stroke or TIA. These findings may support treatment decisions and advanced care planning.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 11","pages":"Article 108448"},"PeriodicalIF":1.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in subtypes, risk profiles, and mortality for cancer among 19,702 Japanese patients with ischemic stroke: A cohort from BioBank Japan","authors":"Takashi Shimoyama MD, PhD ,&nbsp;Yoichiro Kamatani MD, PhD ,&nbsp;Koichi Matsuda MD, PhD ,&nbsp;Hiroki Yamaguchi MD, PhD ,&nbsp;Kazumi Kimura MD, PhD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108449","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108449","url":null,"abstract":"<div><h3>Background</h3><div>Limited data exists on sex-specific differences in cancer subtypes, risk profiles, and mortality among patients with ischemic stroke.</div></div><div><h3>Methods</h3><div>This study analyzed 19,702 ischemic stroke patients (<em>n</em> = 12,241 men; <em>n</em> = 7,261 women) registered in the BioBank Japan database. We compared adjusted odds ratios (aOR) and 95 % confidence intervals (CI) for the prevalence of cancer across 14 common anatomical sites and sex-specific cancers between men and women. A multivariate logistic regression model was used to estimate aORs and 95 %CIs for traditional stroke risk factors associated with a cancer history by sex. Cox proportional hazards regression was used to estimate adjusted hazard ratios (aHR) and 95 %CIs for mortality based on cancer history by sex.</div></div><div><h3>Results</h3><div>Among the 19,702 individuals, 1,656 (8.4 %) had a history of cancer. Men showed significantly higher incidences of gastric (aOR 1.74[1.26-2.41]), bladder (aOR 3.49[1.73-3.03]), kidney (aOR 4.74[1.84-12.25]), and pharyngeal/laryngeal (aOR 6.65[2.17-20.39]) cancers compared to women. Conversely, sex-specific cancers (aOR 0.66[0.52-0.84]) were significantly less common in men than in women. In men, older age (aOR 1.80[1.67-1.94]), chronic kidney disease (aOR 1.73[1.23-2.44]), atrial fibrillation (aOR 1.38[1.07-1.77]), smoking (aOR 1.27[1.09-1.47]), and prior stroke (aOR 1.16[1.02-1.32]) were independently associated with a history of cancer. In women, older age (aOR 1.15[1.05-1.25]) was the only independent factor associated with a cancer history. During a median follow-up of 10 years, a history of cancer increased all-cause mortality risk in both men (aHR 1.27[1.16-1.39]) and women (aHR 1.32[1.14-1.48]).</div></div><div><h3>Conclusion</h3><div>Sex-specific differences in cancer subtypes and risk profiles were present among patients with ischemic stroke.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 11","pages":"Article 108449"},"PeriodicalIF":1.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Miltirone attenuates post-ischemic stroke neuroinflammation and microglial lipid metabolism via regulating LBP and TLR4/NF-κB Axis","authors":"Gui-xian Cai ,&nbsp;Kai-kai Guo","doi":"10.1016/j.jstrokecerebrovasdis.2025.108447","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108447","url":null,"abstract":"<div><h3>Background</h3><div>Ischemic stroke is a leading cause of neurological disability. Current therapies fail to address its multifactorial pathologies. Miltirone, a bioactive compound from Salvia miltiorrhiza, has shown antioxidative and anti-inflammatory potential. However, its neuroprotective mechanisms in stroke remain unexplored.</div></div><div><h3>Methods</h3><div>Using young/aged dMCAO models and OGD/R-treated BV2 microglia, we evaluated Miltirone’s effects on infarct volume, neurological function, microglial polarization, lipid metabolism. Cerebral infarct volume was quantified by TTC staining. Neurological deficits were assessed via mNSS, rotarod, and adhesive removal tests. Cell viability was determined by CCK-8 assay. Pro-/anti-inflammatory cytokines, SOD activity and MDA content were measured by ELISA. Microglial polarization was analyzed via immunofluorescence and RT-qPCR. TLR4/MyD88/NF-κB pathway proteins and PLN2 were analyzed by Western blot. Lipid metabolism was evaluated by BODIPY staining. ROS was measured by flow cytometry</div></div><div><h3>Results</h3><div>Miltirone reduced cerebral infarct volume, attenuated brain edema, and improved neurological/motor recovery in dMCAO mice. It shifted microglial polarization toward the anti-inflammatory M2 phenotype by suppressing M1 markers and enhancing M2 markers. Miltirone downregulated pro-inflammatory cytokines while elevating anti-inflammatory cytokines. Miltirone restored lipid homeostasis by inhibiting lipid synthesis genes and activating lipolysis genes. This reduced lipid accumulation. Mechanistically, Miltirone suppressed LBP expression and TLR4/MyD88/NF-κB pathway. Moreover, Miltirone mitigated oxidative stress by lowering ROS, restoring SOD activity, and reducing lipid peroxidation.</div></div><div><h3>Conclusion</h3><div>Miltirone confers neuroprotection through multi-target actions. It simultaneously provides neuroinflammation, regulates lipid metabolism, and counters oxidative stress. This occurs via LBP/TLR4/NF-κB axis modulation. Its multitarget action addresses the complexity of ischemic stroke pathophysiology, positioning it as a promising therapeutic candidate for clinical translation.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 11","pages":"Article 108447"},"PeriodicalIF":1.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning models for carotid artery plaque detection: A systematic review of ultrasound-based diagnostic performance","authors":"Pooya Eini ,&nbsp;Peyman Eini ,&nbsp;Homa serpoush ,&nbsp;Mohammad Rezayee ,&nbsp;Jason Tremblay","doi":"10.1016/j.jstrokecerebrovasdis.2025.108446","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108446","url":null,"abstract":"<div><h3>Background</h3><div>Carotid artery plaques, a hallmark of atherosclerosis, are key risk indicators for ischemic stroke, a major global health burden with 101 million cases and 6.65 million deaths in 2019. Early ultrasound detection is vital but hindered by manual analysis limitations. Machine learning (ML) offers a promising solution for automated plaque detection, yet its comparative performance is underexplored. This systematic review and meta-analysis evaluates ML models for carotid plaque detection using ultrasound.</div></div><div><h3>Methods</h3><div>We searched PubMed, Scopus, Embase, Web of Science, and ProQuest for studies on ML-based carotid plaque detection with ultrasound, following PRISMA guidelines. Eligible studies reported diagnostic metrics and used a reference standard. Data on study characteristics, ML models, and performance were extracted, with risk of bias assessed via PROBAST+AI. Pooled sensitivity, specificity, AUROC were calculated using STATA 18 with MIDAS and METADTA modules.</div></div><div><h3>Results</h3><div>Of ten studies, eight were meta-analyzed (200–19,751 patients) Best models showed a pooled sensitivity 0.94 (95% CI: 0.88–0.97), specificity 0.95 (95% CI: 0.86–0.98), AUROC 0.98 (95% CI: 0.97–0.99), and DOR 302 (95% CI: 54–1684), with high heterogeneity (I² = 90%) and no publication bias.</div></div><div><h3>Conclusion</h3><div>ML models show promise in carotid plaque detection, supporting potential clinical integration for stroke prevention, though high heterogeneity and potential bias highlight the need for standardized validation.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 11","pages":"Article 108446"},"PeriodicalIF":1.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of premature atherosclerosis with ischemic stroke in young people with HIV in Lusaka, Zambia","authors":"Stanley Zimba ,&nbsp;Owen Ngalamika ,&nbsp;Emmanuel Mukambo ,&nbsp;Theresa Shankanga ,&nbsp;Bwalya Mulenga ,&nbsp;Mike Chisha ,&nbsp;Violet Kayamba ,&nbsp;Lloyd Mulenga ,&nbsp;Omar Siddiqi ,&nbsp;Owen A. Ross ,&nbsp;Masharip Atadzhanov ,&nbsp;Deanna Saylor","doi":"10.1016/j.jstrokecerebrovasdis.2025.108445","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108445","url":null,"abstract":"<div><h3>Background</h3><div>Premature atherosclerosis has been observed among people with HIV (PWH) with high risk of cerebrovascular disease. The aim of this study was to evaluate premature atherosclerosis in young PWH with and without ischemic stroke.</div></div><div><h3>Methods</h3><div>We conducted a prospective case-control study at the University Teaching Hospital in Lusaka, Zambia between March 2022 and October 2024, comparing young PWH with non-cardioembolic ischemic stroke (cases) with PWH without a history of stroke (controls) matched (1:2) for age, sex and race. Premature atherosclerosis was assessed using a Mindray DC-40, linear probe 8-13 MHz high resolution B-mode ultrasound to measure carotid intima-media thickness (cIMT; abnormal≥0.70 mm) and pulse wave velocity (PWV; abnormal≥10.00m/s).</div></div><div><h3>Results</h3><div>We analyzed results for 50 cases and 100 controls. Compared to controls, cases were more likely to have traditional stroke risk factors such as hypertension (42 % vs. 1 %, <em>p</em>=0.001); shorter duration from HIV diagnosis (&lt;3 months: 16 % vs. 1 %, <em>p</em>=0.001);and markers of atherosclerotic disease, including higher PWV [10.89 (9.99-12.15) m/s vs. 8.97 (8.16 - 9.54) m/s, <em>p</em>&lt;0.001] and increased cIMT [0.79 (0.70-0.99) mm vs. 0.63 (0.58 - 0.67) mm, <em>p</em>&lt;0.001]. Poor WHO HIV clinical stage (stage 3: aOR 58, 95 % CI 1-3213, <em>p</em>=0.04), higher PWV (aOR 8.7, 95 % CI 2.0-38.1, <em>p</em>=0.004) and urban residence (aOR 25.5, 95 % CI 1.6-413.4, <em>p</em>=0.02) were independently associated with ischemic stroke in multivariable analyses.</div></div><div><h3>Conclusion</h3><div>In this cohort of young-onset HIV-associated non-cardioembolic ischemic stroke, premature atherosclerosis, as indicated by higher PWV, was independently associated with stroke.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 11","pages":"Article 108445"},"PeriodicalIF":1.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between number of missing teeth and stroke risk: an analysis of NHANES 2011-2020 data","authors":"Dajin Li ,&nbsp;Min You ,&nbsp;Yan Rong ,&nbsp;Lina Wang ,&nbsp;Sijin Peng ,&nbsp;Feifei Shi ,&nbsp;Xiaoli Sun ,&nbsp;Yueguang Liang ,&nbsp;Ting Wang","doi":"10.1016/j.jstrokecerebrovasdis.2025.108442","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108442","url":null,"abstract":"<div><h3>Background</h3><div>Stroke is the second leading cause of death globally and the third leading cause of disability, severely impacting quality of life and increasing healthcare costs. Identifying underlying causes is critical for effective management. Oral health is closely linked to stroke occurrence, and tooth loss is a common oral health issue. However, few studies have explored the relationship between the number of missing teeth and stroke. This study aimed to elucidate the association between the number of missing teeth and stroke.</div></div><div><h3>Methods</h3><div>This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES). The number of missing teeth was assessed by professional dentists. To examine the relationship between tooth loss and stroke risk, multivariable logistic regression analysis and restricted cubic splines (RCS) were employed. Subgroup analyses were further conducted to verify the consistency of findings across populations.</div></div><div><h3>Results</h3><div>The study enrolled 23,473 adult participants, of whom 4.19 % had a history of stroke. Participants diagnosed with stroke exhibited a higher number of missing teeth compared to those without stroke. In a model adjusted for multiple variables, each additional missing tooth was associated with a 2 % increased likelihood of stroke (OR = 1.02, 95 % CI: 1.01, 1.03). Participants with total tooth loss had a 163 % higher incidence of stroke compared to those with no missing teeth (OR = 2.63, 95 % CI: 1.90, 3.62). The RCS curve revealed a significant nonlinear positive correlation between the number of missing teeth and stroke risk.</div></div><div><h3>Conclusions</h3><div>A significant positive association between the number of missing teeth and stroke was observed among U.S. adults. Further large-scale, rigorously controlled studies are warranted to validate the reliability and generalizability of these findings.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 11","pages":"Article 108442"},"PeriodicalIF":1.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144911566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of dementia following stroke subtypes: a study integrating the GBD database and Mendelian randomization","authors":"Meng Jin ,&nbsp;Jingjing Liu ,&nbsp;Ziyi Bao ,&nbsp;Xiaqing Hong ,&nbsp;Songbin He ,&nbsp;Feng Gao","doi":"10.1016/j.jstrokecerebrovasdis.2025.108443","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108443","url":null,"abstract":"<div><h3>Background</h3><div>A large number of studies have previously established a causal association between stroke and dementia, and have demonstrated a strong correlation between ischemic or hemorrhagic stroke and all-cause dementia, respectively. Given the overall increasing prevalence of all-cause dementia worldwide and the absence of data from randomized clinical trials confirming the existence of effective dementia interventions.The aim of this paper is to apply the GBD database to estimate the proportion and trends of dementia following ischemic and hemorrhagic strokes globally and within regions, and to discuss potential risk factors for vascular dementia using Mendelian randomization (MR).</div></div><div><h3>METHODS</h3><div>Using a literature review and Bayesian regression analysis, we estimated the relative risk of dementia following ischemic and hemorrhagic stroke. The proportion of dementia attributable to cerebral infarction and cerebral hemorrhage (PAF) and the burden of dementia under specific clinical etiology-year-sex-region were then calculated in conjunction with the Global Burden of Disease Study (GBD) burden of disease data. And projections were made for the next 10 years. Using the GWAS database, data on vascular dementia and 17 risk factors were collected, and causality was determined by two-sample MR analysis. In addition, potential mediators of risk factor effects on vascular dementia were searched from 338 cerebrospinal fluid metabolites by two-step MR.</div></div><div><h3>RESULTS</h3><div>The relative risk of dementia following cerebral hemorrhage ( relative risk(RR):3.02[1.17-7.78],P&lt;0.001 ) was higher than that of cerebral infarction (RR: 2.07[1.47-2.96], P&lt;0.001). However, due to the high prevalence of cerebral infarction, the PAF for dementia due to cerebral infarction was higher than that of cerebral hemorrhage. Together, they explain 1.31% (1.41%-1.21%) of global dementia. The burden of dementia following both cerebral infarction and cerebral hemorrhage showed significant spatial and temporal heterogeneity. Four causal associations were replicated in two-sample MR and a mediating role for cerebrospinal fluid(CSF) metabolites X-11261 was identified by 2-step MR.</div></div><div><h3>INTERPRETATION</h3><div>one point three one percent of dementia prevalence globally could be explained by ischemic stroke and hemorrhagic stroke.Quantifying the proportion of dementia caused by these two conditions has helped us to gain a comprehensive understanding of the causes of dementia.Through two-sample MR study and two-step MR analysis, modifiable risk factors and cerebrospinal fluid mediators associated with vascular dementia were identified, elucidating intervention methods for preventing or delaying the typical characteristics of dementia. This is crucial for future efforts in disease prevention and treatment.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 11","pages":"Article 108443"},"PeriodicalIF":1.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144911565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between index symptom and timing on perioperative stroke rate in patients undergoing carotid endarterectomy","authors":"Rodolfo Pini ,&nbsp;Gianluca Faggioli ,&nbsp;Gert J de Borst ,&nbsp;Marcello Lodato ,&nbsp;Andrea Vacirca ,&nbsp;Gemmi Sufali ,&nbsp;Enrico Gallitto ,&nbsp;Cristina Rocchi ,&nbsp;Mauro Gargiulo","doi":"10.1016/j.jstrokecerebrovasdis.2025.108441","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108441","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>Carotid endarterectomy (CEA) in symptomatic carotid stenosis (SCS) may have a higher risk of perioperative stroke due to disease severity or hemorrhagic conversion. This study aimed to evaluate CEA outcomes for SCS and examine causes of post-operative stroke based on intervention timing and preoperative symptoms.</div></div><div><h3>Methods</h3><div>All CEAs performed for SCS from 2012 to 2023 across two metropolitan hospitals were analyzed. CEAs were performed with general anesthesia, patching, and shunting. Post-operative (30-day) strokes were classified as technical, hemorrhagic, or embolic and were evaluated by timing (&lt;48 h, 48h–2 weeks, &gt;2 weeks) and preoperative symptoms (TIA/amaurosis fugax, minor stroke, moderate-severe stroke, crescendo TIAs/stroke in evolution). Stroke severity was assessed using the modified Rankin Scale (mRS).</div></div><div><h3>Results</h3><div>Among 664 CEAs, post-operative stroke occurred in 3.0 % of cases. Timing significantly influenced stroke rates: 5.7 % &lt;48 h, 4.0 % between 48h–2 weeks, and 1.4 % &gt;2 weeks (<em>P</em> = .04). Preoperative symptoms also affected stroke rates, with highest rates following crescendo TIAs/stroke in evolution (7.5 %, <em>P</em> = .02). Early CEA (&lt;48 h) independently increased stroke risk (odds ratio 5.6, <em>P</em> = .04), and hemorrhagic strokes were associated with &lt;48 h interventions (<em>P</em> = .005). Major strokes occurred in 1.1 % of cases, linked to preoperative symptoms (<em>P</em> = .05), but not intervention timing.</div></div><div><h3>Conclusions</h3><div>CEA for SCS carries an acceptable stroke risk overall, though early intervention (&lt;48 h) increases hemorrhagic stroke risk. Major strokes are more frequent following crescendo TIA/stroke in evolution, with no association to timing.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 11","pages":"Article 108441"},"PeriodicalIF":1.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144919864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The serum levels and clinical significance of ferroptosis markers in patients with aneurysmal subarachnoid hemorrhage who underwent aneurysm clipping surgery","authors":"Xiaoli Wu,&nbsp;Xiqi Hu,&nbsp;Ying Xia,&nbsp;Bo Wang","doi":"10.1016/j.jstrokecerebrovasdis.2025.108440","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108440","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to explore the association between ferroptosis markers and postoperative prognosis in patients with aneurysmal subarachnoid hemorrhage (aSAH) who underwent aneurysm clipping. Specifically, we evaluated the predictive value of ferroptosis markers in determining post-operative outcomes.</div></div><div><h3>Methods</h3><div>We conducted a prospective observational study involving 210 aSAH patients who underwent aneurysm clipping surgery at our institution from October 2021 to May 2023. Blood samples were collected at postoperative days 1, 3, 7, and 30 to assess the levels of ferroptosis markers (ACSL4, SLC7A11, GPX4) and inflammatory cytokines (CRP, IL-6, TNF-α) using enzyme-linked immunosorbent assay (ELISA). Clinical data were recorded at baseline. Postoperative prognosis was assessed using the modified Rankin Scale (mRS) at 30 days post-surgery. All patients included in the study underwent aneurysm clipping surgery as their primary treatment modality.</div></div><div><h3>Results</h3><div>The serum levels of ACSL4 and IL-6 were significantly higher in the mRS 3-6 group compared to the mRS 0-2 group at all time points. In contrast, SLC7A11 and GPX4 levels were significantly lower in the mRS 3-6 group. Spearman’s correlation analysis revealed a significant negative correlation between ACSL4 and GPX4 and a positive correlation between ACSL4 and IL-6 levels. ROC curve analysis demonstrated that ACSL4 had the highest predictive value for poor postoperative prognosis, with an area under the curve (AUC) of 0.757. Multivariate logistic regression analysis identified aneurysm size, GCS, SLC7A11, ACSL4, GPX4, and IL-6 as independent risk factors for poor postoperative prognosis.</div></div><div><h3>Conclusion</h3><div>Serum ferroptosis markers, particularly ACSL4, along with inflammatory markers, have significant potential in predicting the postoperative prognosis of aSAH patients. These markers could serve as useful biomarkers for early risk stratification and clinical decision-making in aSAH management.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 11","pages":"Article 108440"},"PeriodicalIF":1.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}