Inflammatory Markers and Conventional Atherosclerotic Risk Factors in Acute Ischemic Stroke: Comparative Study between Vascular Disease Subtypes
Nijasri C Suwanwela MD*, Aurauma Chutinet MD*, Kammant Phanthumchinda MD*
Affiliation : * Neurological Unit, Department of Medicine, Faculty of Medicine, Chulalongkorn University
Background : Large vessel atherosclerosis and small vessel disease are two major causes of ischemic stroke. In
patients with large vessel disease, the lesions can be located in the extracranial carotid or intracranial
arteries.
Objective : To search for the differences of risk factors and inflammatory markers among patients with each
subtype of vascular disease.
Materials and Methods : Patients with acute ischemic stroke who had large vessel atherosclerosis or small
vessel disease were studied. Patients with large vessel atherosclerosis were subdivided into extracranial
carotid and intracranial stenosis groups. Blood samples were collected for c-reactive protein, erythrocyte
sedimentation rate, hemoglobin A1C, fibrinogen, fasting plasma glucose, cholesterol, triglyceride, and low-
density and high-density lipoproteins. Risk factors and results of the blood tests between the groups of
patients were compared.
Results : There were 116 patients in the study. Sixty-three patients had large vessel disease, whereas 53
patients had small vessel disease. More prevalence of diabetes and higher c-reactive protein were signifi-
cantly found in patients with large vessel disease. c-reactive protein on admission was also higher in patients
with extracranial carotid stenosis than those with intracranial stenosis. Serum cholesterol and low-density
lipoprotein was significantly higher in patients with intracranial stenosis than those with small vessel
extracranial disease.
Conclusion : Diabetes and higher c-reactive protein on admission were associated with large vessel disease.
c-reactive protein was also higher in patients with extracranial carotid stenosis but their cholesterol and low-
density lipoprotein were significantly lower than those with intracranial disease.
Keywords : Inflammatory markers, Risk factor, Ischemic stroke, Large vessel atherosclerosis, Small vessel disease, Intracranial stenosis, Extracranial carotid disease
