Endovascular treatment of cerebrovascular stenosis with stent for patients with ischemic cerebrovascular disease

Higher serum cystatin C and matrix metalloproteinase 9 levels effectively predict in-stent restenosis after stent implantation for intracranial and extracranial arterial stenosis

OBJECTIVE

This paper was performed to unravel the predictive value of serum cystatin C (Cys C) and matrix metalloproteinase 9 (MMP-9) levels before vascular stent implantation for in-stent restenosis (ISR) 6-12 months after stent implantation for intracranial and extracranial arterial stenosis.

METHODS

One hundred and ninety-eight patients who underwent dilatation stenting for intracranial and extracranial arterial stenosis and completed Digital Subtraction Angiography or head and neck CT- Angiography review were selected for the study and were divided into ISR group (n = 33) and no ISR (NISR) group (n = 165) according to the presence or absence of ISR. Serum levels of Cys C, MMP-9, triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), uric acid (UA), creatinine (Cr), homocysteine (Hcy), fibrinogen (FIB), total bilirubin (TBIL), endothelin-1 (ET-1), nitric oxide (NO), angiotensin II (Ang II), interleukin-6 (IL-6), tumor necrosis factor (TNF-α), and C-reactive protein (CRP) levels before vascular stent implantation were examined and compared between groups. ROC curves were employed for analyzing the predictive value of serum Cys C and MMP-9 alone or in combination for ISR. Pearson test was utilized for analyzing the serum Cys C and MMP-9 with vasoactive substances and inflammatory cytokines in patients in the ISR group. Logistic regression analysis was implemented to analyze the factors influencing ISR 6-12 months after stent implantation for intracranial and extracranial arterial stenosis.

RESULTS

Cys C, MMP-9, LDL, UA, Cr, Hcy, FIB, ET-1, NO, Ang II, IL-6, TNF-α, and CRP were higher in the ISR group than in the NISR group, and TBIL was lower than in the NISR group (P < 0.05). The AUC of the combined serum Cys C and MMP-9 (AUC = 0.900) was greater than that of Cys C (AUC = 0.685) or MMP-9 (AUC = 0.870) alone (P < 0.05). Cys C and MMP-9 levels were positively correlated with ET-1, NO, Ang II, IL-6, TNF-α, and CRP (r > 0, P < 0.05). Increased levels of Cys C, MMP-9, LDL-C, UA, Cr, Hcy, FIB, ET-1, NO, Ang II, IL-6, TNF-α, and CRP, and diabetes were risk factors for the development of ISR (OR > 1, P < 0.05), and TBil was protective factor (OR < 1, P < 0.05).

CONCLUSION

Serum Cys C combined with MMP-9 levels are effective in predicting ISR.

Silencing lncRNA GABPB1-AS1 alleviates cerebral ischemia reperfusion injury through the miR-641/NUCKS1 axis

OBJECTIVE

To investigate the possible mechanism of lncRNA GA binding protein transcription factor beta subunit 1 antisense RNA 1 (GABPB1-AS1) in cerebral ischemia/reperfusion (CI/R) injury.

METHODS

RT-qPCR was applied to determine GABPB1-AS1 expression in oxygen-glucose deprivation/reoxygenation (OGD/R) cells. The targeting relationships between GABPB1-AS1 and miR-641, as well as between miR-641 and nuclear casein and cyclin-dependent kinase substrate 1 (NUCKS1) were examined by dual luciferase reporter assay. The protein expression of caspase-3, Bax, Bcl-2 and NUCKS1 was examined by western blot. Cell apoptosis was measured by flow cytometry (FCM) and western blot. Cell viability was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay.

RESULTS

GABPB1-AS1 was significantly elevated in SH-SY5Y cells under OGD/R. Downregulation of GABPB1-AS1 accelerated cell viability and suppressed cell apoptosis. GABPB1-AS1 silencing reduced ROS and MDA levels in OGD/R-treated cells. Furthermore, miR-641 inhibitor aggravated damage from OGD/R, but GABPB1-AS1 silencing notably attenuated this effect. NUCKS1 was proven to be a target gene of miR-641.

CONCLUSION

GABPB1-AS1 silencing alleviated CI/R injury through the miR-641/NUCKS1 axis, indicating that GABPB1-AS1 might serve as a therapeutic target for CI/R injury.

The negative affectivity dimension of Type D personality associated with increased risk for acute ischemic stroke and white matter hyperintensity

OBJECTIVE

This study was conducted to examine the relationship among type D personality, acute ischemic stroke (AIS), and white matter hyperintensity (WMH).

METHODS

In a cross-sectional study conducted between September 2020 and June 2021, 235 patients aged 50-85 years with first-ever ischemic cerebrovascular disease, including 146 males and 89 females, were enrolled. All participants underwent the Type D Scale-14 test containing negative affectivity (NA) and social inhibition (SI) subscales. Clinical and laboratory data were also collected for analysis. The patients were divided into the AIS group (n = 148) and the transient ischemic attack (TIA) group (n = 87) according to whether there was an acute lesion.

RESULTS

Patients with type D personality had a higher frequency of AIS and LAA and a higher level of WMH. Multiple logistic regression showed that the NA score was related to a 1.11-fold increase in the odds of AIS (95% CI: 1.03-1.19). Neither NA nor SI showed a clear association with a higher frequency of LAA. Higher scores of NA (OR = 1.07, 95% CI: 1.01-1.15), SI (OR = 1.11, 95% CI: 1.03-1.19), and the interaction between the two dimensions (OR = 1.03, 95% CI: 1.01-1.05) were independently associated with an increased load of WMH.

CONCLUSION

Type D personality was related to AIS and WMH. In particular, it was NA, not SI, affected the occurrence of AIS. Our findings may provide new insights regarding behavioral vulnerability for the development of cerebrovascular disorders.

Analysis of the expression levels of chemerin, ox-LDL, MMP-9, and PAPP-A in ICVD patients and their relationship with the severity of neurological impairment

OBJECTIVE

The study aimed to analyze the relationship between expression levels of chemerin, oxidized low density lipoprotein (ox-LDL), matrix metalloproteinase 9 (MMP-9) and pregnancy associated plasma protein A (PAPP-A) in ischemic cerebrovascular disease (ICVD) patients and the relationship between the mentioned indicators and the degree of neurological impairment.

METHODS

From January 2020 to February 2021, a total of 328 cases of ICVD patients were admitted to our hospital, and 240 cases of healthy people (control group) were prospectively recruited into this study. The 328 patients were divided into 2 ischemic subtypes, with 233 cases as acute cerebral infarction (ACI) and 95 cases as transient ischemic attack (TIA). Laboratory tests were compared among the groups. Spearman rank correlation was used to analyze the correlation between chemerin, ox-LDL, MMP-9, PAPP-A levels and neurological deficit. Unconditional logisitic regression was used to analyze the risk factors for neurological deficits.

RESULTS

The high density lipoprotein cholesterol (HDL-C), fasting plasma glucose (FPG), chemerin, ox-LDL, MMP-9, and PPAP-A levels in the ACI group were significantly higher than those in the TIA group and control group (p < 0.05, respectively), while the levels of the mentioned indicators in the TIA group were significantly higher than those in control group (p < 0.05, respectively). The levels of the given indicators decreased successively in the severe, moderate, and mild neurological deficits population and control group, with statistical difference. Spearman rank correlation analysis showed that chemerin, ox-LDL, MMP-9, and PPAP-A levels were positively correlated with the degree of neurological deficit in ICVD patients. Unconditional logistic regression analysis showed that chemerin, ox-LDL, MMP-9, and PPAP-A were the independent risk factors for neurological deficit in patients with ICVD.

CONCLUSION

LDL-C, FPG, chemerin, ox-LDL, MMP-9, and PPAP-A were highly expressed in ACI and neurological deficit patients. Chemerin, ox-LDL, MMP-9, and PPAP-A may be the independent risk factors for neurological deficit in patients with ICVD.

Effects of chemerin and homocysteine levels and their associations with occurrence and development of ischemic cerebrovascular disease

Background

The current study was conducted to explore the effects of chemerin and homocysteine (Hcy) levels and their associations with the occurrence and development of ischemic cerebrovascular disease (ICVD).

Methods

There involved a total of 187 patients with ICVD and 190 healthy people for physical examination in Cangzhou Central hospital from January 2020 to April 2021. The participants enrolled were divided into four groups based on the digital subtraction angiography: mild stenosis group (64 cases, stenosis rate 30-49 %), moderate stenosis group (72 cases, stenosis rate 50-69 %), severe stenosis group (51 cases, stenosis rate 70-99 %) and control group (190 cases, in healthy condition). The laboratory indexes of ICVD group and control group were observed and the four groups were further compared. Pearson linear correlation was applied to analyze the link between chemerin and Hcy levels and the degree of cerebral vascular stenosis in ICVD patients, and multivariate logistic regression was used to analyze the influencing factors of ICVD.

Results

No significant difference was found in general information including age, gender, body mass index (BMI), heart rate, systolic blood pressure, diastolic blood pressure, smoking and drinking between the two groups (P > 0.05). Moreover, there was no significant difference in fasting blood glucose (FBG), total cholesterol (TC) and high density lipoprotein cholesterol (HDL-C) levels between the two groups (P > 0.05). However, the levels of triglyceride (TG), low density lipoprotein cholesterol (LDL-C), chemerin and Hcy in ICVD group were significantly higher than those in control group (P < 0.05). When comparing the four groups, there was no significant difference in FBG and TC levels (P > 0.05). The levels of TG, LDL-C, chemerin and Hcy in mild, moderate and severe stenosis groups were higher than those in control group, the above levels in moderate and severe stenosis group were higher than those in mild stenosis group, and severe stenosis group higher than moderate stenosis group (P < 0.05). Chemerin and Hcy levels were positively correlated with the degree of cerebral vascular stenosis in ICVD patients (r = 0.612, 0.519, P < 0.001). ICVD was regarded as the dependent variable, and the abovementioned general data as well as significant laboratory indicators, including TG, LDL-C, chemerin and Hcy, as independent variables. The results of multivariate logistic regression analysis revealed that TG, LDL-C, chemerin and Hcy were independent influencing factors of ICVD.

Conclusions

Chemerin and Hcy levels exerted a close link to the occurrence and development of ICVD as independent influencing factors.