Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"Admission red blood cell distribution width as a prognostic biomarker of stroke-associated pneumonia and mortality in acute ischemic stroke patients treated with thrombolysis","authors":"Sarawut Krongsut ,&nbsp;Nat Na-Ek ,&nbsp;Nop Khongthon","doi":"10.1016/j.jstrokecerebrovasdis.2025.108254","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108254","url":null,"abstract":"<div><h3>Background</h3><div>Red blood cell distribution width (RDW) is an inflammatory marker potentially linked to stroke-associated pneumonia (SAP). This study assessed RDW's role in predicting SAP, mortality, and poor outcomes in acute ischemic stroke (AIS) patients treated with thrombolysis.</div></div><div><h3>Methods</h3><div>A retrospective analysis (2015–2022) of AIS patients treated with thrombolysis examined admission RDW levels. Outcomes included SAP, in-hospital (IHM) and 3-month mortality, and poor functional outcomes. Associations were analyzed using multivariable logistic regression, with predictive performance assessed via area under a receiver operating characteristic curve (AuROC), net reclassification index (NRI), and integrated discrimination improvement (IDI) metrics.</div></div><div><h3>Results</h3><div>Of 345 patients, 70 (20.3 %) developed SAP. A 1-SD increase in RDW was associated with SAP (adjusted odds ratio [aOR]: 1.73; 95 % CI: 1.27–2.35), IHM (aOR: 2.14; 95 % CI: 1.43–3.21), and 3-month mortality (aOR: 1.74; 95 % CI: 1.19–2.56). The association was stronger in non-diabetics and those under 65. Although RDW did not improve the AuROC for SAP or mortality predictions, it significantly improved the NRI and IDI (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>RDW is independently associated with increased risk of SAP, IHM, and 3-month mortality in AIS patients treated with thrombolysis, suggesting its potential as a prognostic marker.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 4","pages":"Article 108254"},"PeriodicalIF":2.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The health-related quality of life among stroke survivors with post-COVID conditions living in the United States","authors":"Seyyed Sina Hejazian ,&nbsp;Ajith Vemuri ,&nbsp;Alireza Vafaei Sadr ,&nbsp;Shima Shahjouei ,&nbsp;Sasan Bahrami ,&nbsp;Vida Abedi ,&nbsp;Ramin Zand","doi":"10.1016/j.jstrokecerebrovasdis.2025.108246","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108246","url":null,"abstract":"<div><h3>Background and aim</h3><div>It is widely recognized that a considerable number of COVID-19 survivors continue to experience post-COVID conditions (PCCs). Given that stroke survivors face a heightened risk of PCCs compared to the general population, our objective was to assess the impact of PCCs on the health-related quality of life (HRQL) among stroke survivors in the United States.</div></div><div><h3>Method</h3><div>We used the Behavioral Risk Factor Surveillance System data 2022. Respondents with a history of COVID-19 infection and stroke were selected and classified based on whether they experienced PCCs. Finally, the HRQL-related items, including self-reported general health (SRGH), the number of days with compromised mental and physical health, and the daily efficiency, were compared between the two groups.</div></div><div><h3>Results</h3><div>Overall, 3988 respondents (42.8 % aged above 64 years old, 45.8 % men) were enrolled. Compared to stroke survivors without PCCs, those with PCCs had significantly worse SRGH and a higher number of days with compromised mental and physical health. However, although multivariate regression analysis supported the adverse impact of PCCs on the SRGH of stroke survivors, the results were not statistically significant (aOR = 1.32,CI95 %:[0.98-1.78],p = 0.070). Fatigue and dyspnea emerged as the most significantly associated symptoms with impaired SRGH. Additionally, lower education and annual household income level, smoking, lack of physical activity, and comorbidities including diabetes, heart, and pulmonary disease were associated with a higher prevalence of unfavorable SRGH among stroke survivors with PCCs.</div></div><div><h3>Conclusion</h3><div>Our study highlights that PCCs might be associated with worse SRGH. Lower education, income, and physical activity, smoking, and comorbidities were associated with a higher rate of unfavorable SRGH among stroke survivors with PCCs.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 4","pages":"Article 108246"},"PeriodicalIF":2.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Door-to-Needle Time Trends After Transition to Tenecteplase: A Multicenter Texas Stroke Registry\" [Journal of Stroke and Cerebrovascular Diseases 33 (2024) 107774].","authors":"Nathaniel Rodriguez, Sidarrth Prasad, DaiWai M Olson, Sujani Bandela, Gretchel Gealogo Brown, Yoon Kwon, Mehari Gebreyohanns, Erica M Jones, Nneka L Ifejika, Suzanne Stone, Jane A Anderson, Sean I Savitz, Salvador Cruz-Flores, Steven J Warach, Mark P Goldberg, Lee A Birnbaum","doi":"10.1016/j.jstrokecerebrovasdis.2025.108250","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108250","url":null,"abstract":"","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108250"},"PeriodicalIF":2.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069732","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":"Thrombolysis in lacunar stroke: Comparison of early neurological improvement and 90-day functional outcome with cardioembolic stroke without large-vessel occlusion","authors":"Ádám Annus MD, PhD ,&nbsp;Nikolett Halmai MD ,&nbsp;Evelin Fehér PhD ,&nbsp;Gábor Tárkányi MD ,&nbsp;László Szapáry MD, PhD, DSc ,&nbsp;István Szegedi MD, PhD ,&nbsp;László Csiba MD, PhD, DSc ,&nbsp;László Vécsei MD, PhD, DSc ,&nbsp;László Sztriha MD, PhD, FRCP ,&nbsp;Péter Klivényi MD, PhD, DSc","doi":"10.1016/j.jstrokecerebrovasdis.2025.108245","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108245","url":null,"abstract":"<div><h3>Introduction</h3><div>Thrombolysis (IVT) is effective in the treatment of lacunar stroke (LAC). However, most studies compared the outcome of LAC to a heterogenous control group. We aimed to compare early neurological improvement (ENI) and late functional outcomes following thrombolysis for LAC with a homogenous control group of cardioembolic stroke (CE) without large-vessel occlusion (LVO).</div></div><div><h3>Patients and methods</h3><div>Patient data were obtained from the national multicentre STAY ALIVE Acute Stroke Registry. At each centre, a team of vascular neurologists determined the TOAST classification. ENI was defined as a minimum 4-point decrease in the NIHSS score between admission and discharge, or a complete resolution of symptoms. For late functional outcome, we analysed the dichotomised 90-day mRS scores (good outcome was mRS≤2).</div></div><div><h3>Results</h3><div>142 LAC and 156 CE patients were analysed. Following IVT, the percentage of ENI did not differ significantly (LAC 41.1% vs CE 49.7%, p=0.154), and multivariable analysis did not identify any clinical parameters that would predict ENI after IVT in either group. LAC patients had unfavourable, albeit non-significant, odds of having good 90-day functional outcomes compared to CE patients (aOR 0.483, 95% CI 0.201-1.161, p=104).</div></div><div><h3>Conclusions</h3><div>We report the first analysis of short- and long-term outcomes of IVT in LAC, using a homogenous control group of CE patients without LVO. The prevalence of ENI and 90-day functional outcomes were similar. However, LAC patients had unfavourable odds of achieving good functional outcomes compared to the control group. Therefore, we emphasise that LAC should not be considered a minor stroke subtype.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 4","pages":"Article 108245"},"PeriodicalIF":2.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between heart rate variability traits and stroke: A Mendelian randomization study","authors":"Wei Liu MM ,&nbsp;Yexin Xin MM ,&nbsp;Mengyu Sun MM ,&nbsp;Chenlong Liu MM ,&nbsp;Xiangrong Yin MM ,&nbsp;Xiaofei Xu PhD ,&nbsp;Yilei Xiao PhD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108251","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108251","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Previous observational studies have suggested a potential association between heart rate variability (HRV) and cerebrovascular disease. However, a causal relationship between the two has not yet been established.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aims&lt;/h3&gt;&lt;div&gt;The objective of this study was to determine the causal relationship between heart rate variability (HRV) and stroke through a two-sample Mendelian randomization analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Three genetic predictive traits of heart rate variability standard deviation of the normal-to-normal interbeat intervals (SDNN), the root mean square of the successive differences of interbeat intervals (RMSSD), and the peak-valley respiratory sinus arrhythmia or high-frequency power (pvRSA/HF) were collected from publicly available genome-wide association studies (IEU Open GWAS). Additionally, stroke (STROKE) and its sub-types: ischemic stroke (IS), cardioembolic stroke (CES), small vessel stroke (SVS), large artery stroke (LAS), lacunar stroke (LS), and intracerebral hemorrhage (ICH)were also from this database. Two-sample Mendelian randomization and various sensitivity analyses were employed to explore the causal relationship between HRV and stroke and its sub-types. Inverse-variance weighted (IVW) was the primary method via which Mendelian randomization (MR) was conducted, and for the causal estimates determined by IVW, a series of sensitivity analyses were performed to assess the reliability of the results. (i) Four additional MR methods that complement IVW were utilized; (ii) Cochran's Q-test was employed for assessing heterogeneity; (iii) the MR-Egger's intercept test and MR-PRESSO global test were applied to assess the level of multivariate validity, and (iv) the \"leave-one-out\" method was utilized to assess stability.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Two of the genetically predictive traits of HRV (standard deviation of the normal-to-normal interbeat intervals [SDNN]) and (the peak-valley respiratory sinus arrhythmia or high-frequency power [pvRSA/HF]) were associated with IS (OR 0.63,95 %CI 0.42-0.95, &lt;em&gt;P =&lt;/em&gt; 0.03), (OR 0.84, 95 %CI: 0.72-1.00; &lt;em&gt;P =&lt;/em&gt; 0.04), and LAS (OR 135.93, 95 %CI: 7.19-2569.22; &lt;em&gt;P =&lt;/em&gt; 0.05), (OR 1.42, 95 %CI: 1.02-1.98; &lt;em&gt;P =&lt;/em&gt; 0.04) were significantly correlated in addition to (pvRSA/HF) and LS (OR 0.84, 95 %CI: 0.72-1.00; &lt;em&gt;P =&lt;/em&gt; 0.04) were also causally associated. Neither was causally associated with other sub-types of stroke or hemorrhagic stroke. Another genetically predictive trait of HRV (the root mean square of the successive differences of interbeat intervals [RMSSD]) was not found to be significantly associated with stroke, its subtypes, or Intracerebral hemorrhage.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This study provides genetic evidence supporting the causal effects of HRV (SDNN) on ischemic stroke (IS) and large artery stroke (LAS), as well as (pvRSA/HF) on ischemic stroke (IS), large artery ","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 4","pages":"Article 108251"},"PeriodicalIF":2.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the genetic causal inference between plasma lipidome and hemorrhagic stroke","authors":"Zhao Yu MM ,&nbsp;Yingjie Shen MD ,&nbsp;Haopeng Zhang MD ,&nbsp;Wei Zhang MM ,&nbsp;Xi Zhang MM ,&nbsp;Yaolou Wang MM ,&nbsp;Chenyi Nie MS ,&nbsp;Jiaxin Zhou MS ,&nbsp;Aili Gao PhD ,&nbsp;Hongsheng Liang MD, PhD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108252","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108252","url":null,"abstract":"<div><h3>Objectives</h3><div>Recent research indicates that the plasma lipidome composition may undergo alterations following hemorrhagic stroke. Nevertheless, the causal inference between plasma lipidome and hemorrhagic stroke remains elusive.</div></div><div><h3>Materials and methods</h3><div>Exposure data were achieved from a recent Genome-wide Association Study (GWAS) study of 179 lipid species involving 7174 individuals, while the outcome data were obtained from the FinnGen consortium (R10), including intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), and non-traumatic intracranial hemorrhage (nITH). Two-sample bidirectional Mendelian randomization (MR) analyses were used to assess the causal inference between lipidome and hemorrhagic stroke, and inverse variance weighted served as the main method. Genetic correlations between lipidome and hemorrhagic stroke were assessed using linkage disequilibrium score regression (LDSC).</div></div><div><h3>Results</h3><div>After the false discovery rate (FDR) correction, Phosphatidylcholine (O-18:2_20:4) was identified as a substantial risk factor for ICH (OR,1.199; 95 % CI, 1.073–1.341; <em>P</em>_FDR = 0.073). Alternatively, Phosphatidylinositol (16:0_18:1) was a relevant protective factor (OR, 0.773; 95 % CI, 0.666–0.896; <em>P</em>_FDR = 0.069). Furthermore, the Sterol ester (27:1/20:3) (OR, 1.138; 95 % CI, 1.024–1.264; <em>P</em>_FDR = 0.086) was identified as the prominent risk factor for SAH. Finally, Sterol ester (27:1/20:4) (OR, 1.073; 95 % CI, 1.026–1.121; <em>P</em>_FDR = 0.030) and Phosphatidylinositol (16:0_18:1) levels (OR, 0.794; 95 % CI, 0.709–0.889; <em>P</em>_FDR = 0.007) was identified as risk and protective factors for nITH, respectively.</div></div><div><h3>Conclusions</h3><div>The causal relationship between plasma lipidome and hemorrhagic stroke is evident. Studying the plasma lipidome offers promising preventive strategies and potential therapeutic approaches for hemorrhagic stroke.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 4","pages":"Article 108252"},"PeriodicalIF":2.0,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-procedural Plasma D-dimer Level May Predict Futile Recanalization in Stroke Patients with Endovascular Treatment.","authors":"Min Zhao, Zhengze Dai, Rui Liu, Xinfeng Liu, Gelin Xu","doi":"10.1016/j.jstrokecerebrovasdis.2025.108248","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108248","url":null,"abstract":"<p><strong>Objective: </strong>High D-dimer levels may increase the likelihood of unfavorable clinical outcomes in patients with acute ischemic stroke. However, the impacts of serum D-dimer levels on outcomes of reperfusion treatment in patients with acute ischemic stroke have not been evaluated. This study aims to assess a possible relationship between serum D-dimer and functional outcomes in stroke patients with endovascular treatment (EVT).</p><p><strong>Methods: </strong>Patients with acute ischemic stroke who underwent successful EVT were enrolled. Plasma D-dimer was measured before and within 6 hours after endovascular procedures. Futile recanalization was defined as a modified Rankin Scale score of 3-6 at 90 days of stroke onset. Multivariable logistic regression analyses were performed to determine the relationships between D-dimer and futile recanalization.</p><p><strong>Results: </strong>Of the 161 enrolled patients, 78 (48.4%) were classified as futile recanalization. After adjusting for potential confounders, high post-procedural D-dimer level was associated with futile recanalization (odds ratio, 1.25; 95% CI, 1.05-1.51; P =0.016). In patients with futile recanalization, change in serum D-dimer levels increased significantly after EVT (P <0.001). Furthermore, change in D-dimer level after EVT was associated with futile recanalization (odds ratio, 1.33; 95% CI, 1.11-1.65; P =0.005) independently.</p><p><strong>Conclusions: </strong>High post-procedural plasma D-dimer levels and a significant increase in D-dimer after EVT may predict futile recanalization in patients with acute ischemic stroke.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108248"},"PeriodicalIF":2.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042811","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":"Corrigendum to “Blockage of p38MAPK in astrocytes alleviates brain damage in a mouse model of embolic stroke through the CX43/AQP4 axis” [J Stroke Cerebrovasc Dis. 2024 Dec;33(12):108085/Article Number: YJSCD_JSCVD-D-24-00861]","authors":"Weiping Chen ,&nbsp;Zhiping Wu ,&nbsp;Min Yin ,&nbsp;Yangbo Zhang ,&nbsp;Yiren Qin ,&nbsp;Xu Liu ,&nbsp;Jianglong Tu","doi":"10.1016/j.jstrokecerebrovasdis.2025.108229","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108229","url":null,"abstract":"","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 3","pages":"Article 108229"},"PeriodicalIF":2.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential of low apolipoprotein A-I as a surrogate marker of vulnerable carotid artery plaques","authors":"Saya Tsuchigauchi MD ,&nbsp;Toshinori Matsushige MD ,&nbsp;Yukishige Hashimoto MD ,&nbsp;Masahiro Hosogai MD ,&nbsp;Hiroki Takahashi MD ,&nbsp;Shohei Kobayashi MD ,&nbsp;Takeo Shishido MD ,&nbsp;Naoyuki Hara MD ,&nbsp;Kenta Kaneyoshi MD ,&nbsp;Shota Uchida MD ,&nbsp;Ryuga Maki MD ,&nbsp;Hiroshi Yamashita MD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108231","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108231","url":null,"abstract":"<div><h3>Objective</h3><div>Recent studies suggested that the medical control of atherogenic lipoproteins is not sufficient for stroke prevention. A low apolipoprotein A-I (apoA-I) level may play a crucial role in the anti-atherogenic effects of high-density lipoprotein (HDL-C) and may also be associated with symptomatic vulnerable plaques in carotid artery stenosis. Therefore, the present study investigated the relationship between apoA-I levels and the status of carotid artery stenosis.</div></div><div><h3>Methods</h3><div>Ninety-one patients with carotid artery stenosis were examined. The status of carotid artery plaques was divided into symptomatic (<em>n</em> = 47) and asymptomatic (<em>n</em> = 44). We examined patient profiles, including comorbidities, and laboratory lipid data, and plaque features visualized by ultrasonography, MRI, and digital subtraction angiography. The relationships between plaque instability and risk factors for carotid artery stenosis were investigated.</div></div><div><h3>Results</h3><div>No significant differences were observed in the profiles of symptomatic and asymptomatic patients. Regarding plaque features, ulceration, low echo luminance, and a high signal intensity in plaques on T1-weighted images correlated with symptomatic plaques. ApoA-I, total cholesterol, and non-HDL-C levels were significantly lower in symptomatic patients than in asymptomatic patients. A multivariate logistic regression analysis identified low ApoA-I levels, ulceration, and low echo luminance as predictive factors for symptomatic carotid artery stenosis. Diagnostic accuracy for predicting symptomatic carotid stenosis was 0.84 when the following four factors were combined: ulceration, low echo luminance, a high signal intensity on T1-weighted images, and the level of apoA-I.</div></div><div><h3>Conclusions</h3><div>A low apoA-I level was associated with symptomatic carotid artery stenosis. Therefore, ApoA-I levels have potential as a surrogate marker to detect unstable carotid artery plaques.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 4","pages":"Article 108231"},"PeriodicalIF":2.0,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between body roundness index and stroke results from the 1999-2018 NHANES","authors":"Jiale Gan ,&nbsp;Xinyi Yang ,&nbsp;Jianan Wu ,&nbsp;Peiyi Mo ,&nbsp;Yongxing Deng ,&nbsp;Yan Liu ,&nbsp;Yang Wu ,&nbsp;Peian Liu ,&nbsp;Lianhong Ji ,&nbsp;Hui Jiang ,&nbsp;Yunfei Han ,&nbsp;Zhaoyao Chen ,&nbsp;Wenlei Li ,&nbsp;Yuan Zhu ,&nbsp;Minghua Wu","doi":"10.1016/j.jstrokecerebrovasdis.2025.108243","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108243","url":null,"abstract":"<div><h3>Importance</h3><div>Obesity, especially visceral obesity, is a controllable risk factor associated with the incidence of stroke. The body roundness index (BRI) bridges the gap between traditional anthropometric methods of assessing fat distribution to predict the percentage of body fat and visceral adipose tissue, which can be used to decipher its population-based characteristics and potential association with stroke.</div></div><div><h3>Objective</h3><div>The negative impact of accumulated visceral obesity on cerebrovascular health has been widely documented. However, the association between BRI and stroke has never been reported before. The purpose of this study was to elucidate the connection between BRI and the general incidence of stroke in the US population.</div></div><div><h3>Design, Setting, and Participants</h3><div>This cohort study extracted cross-sectional data from 39,454 U.S. adults (aged ≥20 years) from documents related to the National Health and Nutrition Examination Survey (NHANES) from 1999 through 2018.</div></div><div><h3>Methods</h3><div>We evaluated the relationship between BRI and stroke using weighted logistic regression analysis, and we looked at any possible nonlinear relationships using restricted cubic spline (RCS) regression. Additionally, subgroup analysis and interaction tests were carried out.</div></div><div><h3>Results</h3><div>The study involved 39,454 participants, of whom 1,427 (3.6 %) had a stroke. Fully adjusted logistic regression models showed that BRI was positively associated with stroke, with a 5.7 % increase in stroke incidence per unit increase in BRI (OR = 1.057, 95 % CI = 1.009,1.108, <em>P</em> = 0.020). RCS analysis revealed a nonlinear association, suggesting an elevated risk of stroke before the inflection point of 8.489. This positive correlation was consistent across settings, according to subgroup analyses and interaction tests (<em>P</em> &gt; 0.05 for all interactions).</div></div><div><h3>Conclusions and relevance</h3><div>There is a nonlinear positive correlation between BRI and stroke, according to this national cohort study. These results support the use of the BRI as a screening tool for assessing stroke risk; yet, because cross-sectional studies have inherent limitations, more thorough research is required until the BRI has been consistently validated in additional independent cohorts.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 3","pages":"Article 108243"},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}