Correlation Between Cerebral Microbleeds And Essen Stroke Risk Score, S100B/RAGE In Acute Ischemic Cerebrovascular Disease

Part I:Correlation between Essen Stroke Risk Score and Distribution of Cerebral Microbleeds in Patients with Acute Ischemic Cerebrovascular DiseaseObjective To investigate the correlation between Essen Stroke Risk Score (ESRS) and the distribution pattern of cerebral microbleeds (CMBs) in patients with acute ischemic cerebrovascular disease.Methods Consecutive patients with acute cerebral infarction or transient ischemic attack (TIA) in Nanjing Stroke Registry System from April 2011 to December 2011 were recruited in the study. The patients were underwent a magnetic resonance imaging protocol including susceptibility-weighted imaging (SWI). The correlations between ESRS and presence/distribution patterns of CMBs foci were analyzed.Results 177 acute cerebral infarction or TIA patients were prospectively enrolled. CMBs were identified in 77 patients (43.50%). Strict lobar CMBs were present in 16 patients, deep or infratentoria CMBs were present in 61 patients. Age (P=0.005), hypertension (P=0.001), previous TIA or ischemic stroke (P=0.021), creatinine (P=0.018), fibrinogen (P=0.023) had significant differences among patients with was confirmed between ESRS and deep or infratentorial CMBs (P<0.001) rather than lobar CMBs (P=0.322). After adjusting for confounders, multinomial logistic regression indicated ESRS might be an independent predictor for deep or infratentorial CMBs (OR 1.745,95% CI 1.341-2.272; P<0.001), but not for the lobar CMBs foci (OR 1.050,95% CI 0.692-1.591; P=0.819). Besides, fibrinogen was an independent determinant for CMBs located in lobar (OR 2.374,95% CI 1.047-5.383; P=0.038).Conclusion ESRS might be helpful in predicting deep or infratentorial CMBs in patients with acute ischemic cerebrovascular disease. Fibrinogen was associated with lobar CMBs.Part â…¡:Correlation between cerebral microbleeds and S100B/RAGE in acute lacunar stroke patientsBackground and purposeS100B combined with its scavenger, soluble receptor for advanced glycation end products (sRAGE), participate in various acute and chronic brain disorders. However, their impact on hemorrhage-prone small vessel disease represented by cerebral microbleeds (CMBs) is unclear. The purpose of this study was to investigate the relationship of CMBs with plasma S100B and sRAGE.MethodsA cohort of 147 consecutive patients with first-ever acute lacunar stroke was prospectively enrolled. We collected demographic, clinical, and laboratory data, including plasma levels of S100B and sRAGE, presence and number of CMBs using susceptibility-weighted imaging (SWI). Associations between plasma S100B, sRAGE levels and the presence, number, and location of CMBs were determined.ResultsCMBs were present in 58 patients (39.5%). Each 1SD-increase in S100B and sRAGE levels was significantly associated with presence of CMBs (adjusted odds ratio [OR], 3.06; 95% confidence interval [CI],1.81-5.17 and adjusted OR,0.29; 95% CI, 0.16-0.53; respectively) and number of CMBs (adjusted relative risk [RR],4.07; 95% CI,3.60-5.65 for S100B and RR 0.34; 95% CI,0.25-0.46 for sRAGE). When stratified by location, plasma S100B and sRAGE levels were similarly associated with presence of deep CMBs (adjusted OR,3.65; 95% CI,1.99-6.69 and adjusted OR,0.23; 95% CI,0.12-0.46; respectively), but not with strictly lobar CMBs.ConclusionsHigher levels of S100B and lower levels of sRAGE are independently associated with a presence and number of CMBs in patients with first-ever acute lacunar stroke, particularly in those with deep CMBs.