We found a high rate of vessel recanalization after IV thrombolysis occlusion. However, recanalization was infrequent in patients with diabetes and extracranial carotid occlusion. Information on recanalization was a powerful, early predictor for clinical outcome.

Age emerged as a highly significant inverse predictor of good functional outcome after ischemic stroke independent of stroke severity, characteristics, and complications with the age-outcome association exhibiting a nonlinear scale and extending to young stroke patients.

We hypothesized that the formation of foam cells and fatty streaks requires a postsecretory oxidative modification of lipoproteins that targets them for rapid uptake by macrophages. Lipid peroxidation may in part depend on the concentration of tissue iron, one of the major oxidants in vivo. We analyzed the relation between sonographically assessed carotid atherosclerosis and body iron stores in a population sample of 847 men and women aged 40 to 79 years. In a logistic regression analysis adjusting for age, sex, and all major vascular risk markers, ferritin emerged as one of the strongest indicators of carotid artery disease in both sexes (40 to 59 R ecent advances in understanding vascular lipid metabolism have yielded new insights into the mechanisms that determine endothelial injury and plaque development. In particular, the postseCTetory modification of lipoproteins has attracted increasing attention.1 Oxidative changes in the surface structure of low-density lipoproteins enhance the affinity to macrophage scavenger receptors, giving rise to the formation of foam cells and fatty streaks. -3 Prominent iron stores may promote lipid peroxidation and accelerate atherogenesis and cardiovascular disease. This hypothesis recently received empirical support from a large population study (Kuopio Ischaemic Heart Disease Risk Factor Study) that demonstrated an enhanced risk of myocardial infarction in middle-aged men with elevated concentrations of serum ferritin.4 These findings, however, do not necessarily imply a causal role of iron in atherogenesis. Enhanced reperfusion injury, direct cardiotoxicity of high myocardial iron deposits, vasospastic events, and increased blood viscosity may also be significant. 57 We designed the current study to investigate the relation between sonographically assessed carotid atherosclerosis and body iron stores as estimated by serum ferritin. 89 We also investigated physiologically normal iron status and addressed sex differences in the amount of body iron and the manifestation of atherosclerotic vascular disease.Received November 30, 1993; revision accepted June 29, 1994. From the Department of Neurology (S.K., F.A., F.G., F.S., J.W.) and Department of Laboratory Medicine (EJ.), University Ginic Innsbruck (Austria), and the Department of Internal Medicine, Hospital of Bruneck (G.E., A.M., G.R., F.O.) (Italy).Correspondence to Dr J. Willeit, Department of Neurology, University of Innsbruck, AnichstraBe 35, A-6020 Innsbruck, Austria.years; odds ratio, 1.54 per 100 /xg/L; P<.001). The predictive significance of ferritin was found to be synergistic with that of hypercholesterolemia. Variations in body iron stores between sexes may partly explain evident sex differences in the expression of carotid atherosclerosis. In the elderly (£60 years) the predictive significance of ferritin was found to decrease parallel to that of apolipoprotein B. The current study suggests a possible role of body iron in early atherogenesis. (ArUriosder Thromb. 1994;14:1625-1630 Key Words • carotid ...

The uACR is significantly and independently associated with the presence and severity of atherosclerosis in the general population. The relation obtained was of a dose-response type and extended to levels far below what is termed microalbuminuria. The novel aspects of our study are its focus on various vascular territories and representivity of the general healthy population.

Background Cardiac amyloidosis (CA) is an underappreciated cause of morbidity and mortality. Light-chain (AL) and transthyretin (ATTR) amyloidosis have different disease trajectories. No data are available on subtype-specific modes of death (MOD) in patients with CA. Methods and results We retrospectively investigated 66 with AL and 48 with wild-type ATTR amyloidosis (ATTRwt) from 2000 to 2018. ATTRwt differed from AL by age (74.6 ± 5.4 years vs. 63 ± 10.8 years), posterior wall thickness (16.8 ± 3.3 mm vs. 14.3 ± 2.2 mm), left ventricular mass index (180.7 ± 63.2 g/m 2 vs. 133.5 ± 42.2 g/m 2), and the proportions of male gender (91.7% vs. 59.1%), atrial enlargement (92% vs. 68.2%) and atrial fibrillation (50% vs. 12.1%). In AL NYHA Functional Class and proteinuria (72.7% vs. 39.6%) were greater; mean arterial pressure (84.4 ± 13.5 mmHg vs. 90.0 ± 11.3 mmHg) was lower. Unadjusted 5-year mortality rate was 65% in AL-CA vs. 44% in the ATTRwt group. Individuals with AL-CA were 2.28 times ([95%CI 1.27-4.10]; p = 0.006) more likely to die than were individuals with ATTRwt-CA. Information on MOD was available in 56 (94.9%) of 59 deceased patients. MOD was cardiovascular in 40 (66.8%) and non-cardiovascular in 16 (27.1%) patients. Cardiovascular [28 (68.3%) vs. 13 (80%)] death events were distributed equally between AL and ATTRwt (p = 0.51). Conclusion Our data indicate no differences in MOD between patients with AL and ATTRwt cardiac amyloidosis despite significant differences in clinical presentation and disease progression. Cardiovascular events account for more than twothirds of fatal casualties in both groups.