Hypothesis of “stroke-stop” formula: a tool for risk index determination in development of acute cerebrovascular disease in asymptomatic individuals with carotid stenosis

BMC Neurology

Stefan Toth¹  Іvan Kopolovets²  Vladimir Sihotsky²  Peter Berek²  Peter Stefanic²  Dmytro Lotnyk³  Zdenka Hertelyova⁴  Rastislav Mucha⁵  Nadiya Boyko⁶ 

[1] Clinic of Cardiology, Eastern Slovak Institute of Cardiovascular Diseases and Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovak Republic;Clinic of Vascular Surgery, Eastern Slovak Institute of Cardiovascular Diseases and Faculty of Medicine, Pavol Jozef Safarik University, Ondavska 8, 04011, Kosice, Slovak Republic;Department of Physics Cornell University Clark Hall, New York, USA;Institute of Experimental Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovak Republic;Institute of Neurobiology, Biomedical Research Center of the Slovak Academy of Sciences, Kosice, Slovak Republic;Uzhhorod National University, Research Development and Educational Center of Molecular Microbiology and Mucosal Immunology, Uzhhorod, Ukraine;

关键词: Atherosclerosis;    Carotid artery stenosis;    Vulnerable plaque;    Vascular markers;    Stroke;    Personalized medicine;   

DOI  :  10.1186/s12883-021-02337-y

来源: Springer

【 摘 要 】

BackgroundExtracranial carotid artery disease is considered a risk factor for developing acute cerebrovascular diseases. The paper suggests the “Stroke-Stop” formula as hypothesis for the determination of the risk of developing stroke in asymptomatic individuals with carotid stenosis. The formula is based on a mathematical calculation of the major risk factors for stroke: the degree of ICA (internal carotid artery) stenosis, the morphological structure of the atherosclerotic plaque and the level of lipoprotein-associated phospholipase A2 (Lp-PLA2) concentration.MethodsThe cross sectional study included 70 patients with atherosclerotic ICA stenosis. Among vascular inflammatory markers, Lp-PLA2 was determined with concentration 252.7–328.6 mg/l. The obtained results were evaluated using descriptive statistics (the frequency, percentage ratio) as well as the one-way analysis of variance (ANOVA) and chi-square test.ResultsThe risk of stroke development is eminently increasing with the progression of ICA stenosis and elevation of Lp-PLA2 levels. In patients with echolucent plaque, the risk of stroke development was significantly higher in correlation with patients with echogenic plaque. Based on calculations using “Stroke-Stop” formula, three main groups were generated: low (< 70 points), medium (70–100 points) and high (> 100 points) risk of stroke development.ConclusionsHypothesis of “Stroke-Stop” formula is proposed for better selection of patients who should be indicated for surgical treatment and will be evaluated in prospective study. In order to verify this hypothesis, we plan to do prospective study using “Stroke-Stop” formula for ipsilateral annual stroke rate in asymptomatic individuals with carotid stenosis who receive conservative therapy.

【 授权许可】

CC BY