Immune-inflammatory markers and arterial stiffness indexes in subjects with acute ischemic stroke with and without metabolic syndrome

Abstract

Objective: The aim of our study was to evaluate the associations between arterial stiffness indexes and immune-inflammatory markers in subjects with acute ischemic stroke with and without metabolic syndrome. Materials/Methods: We enrolled 130 patients with acute ischemic stroke and metabolic syndrome, 127 patients with acute ischemic stroke without metabolic syndrome and 120 control subjects without acute stroke. Applanation tonometry was used to record the augmentation index (Aix) and pulse wave velocity (PWV). We also evaluated plasma levels of C-reactive protein (CRP), Interleukin-1beta (IL-1β), tumor necrosis factor-alpha (TNF-α), Interleukin-6 (IL-6) and Interleukin-10 (IL-10), E-selectin, P-selectin, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), von Willebrand Factor (vWF) plasma levels, tissue plasminogen activator (TPA) and plasminogen activator inhibitor-1 (PAI-1).Results: In subjects with acute ischemic stroke and metabolic syndrome we observed higher median plasma values of immuno-inflammatory markers. In acute ischemic stroke patients and metabolic syndrome in relation of each TOAST subtype we observed a more significant positive correlation between PWV and immuno-inflammatory markers.Conclusions: Stroke subjects with acute ischemic stroke and metabolic syndrome showed a higher degree of immuno-inflammatory and arterial stiffness indexes possibly due to metabolic background of these types of patients that trigger a more intense immune-inflammatory activation irrespective of stroke subtype, whereas being related to stroke subtype in subjects without metabolic syndrome.

Increased expression of markers of early atherosclerosis in patients with inflammatory bowel disease

“…Therefore, the key clinical question is whether the incidence of cardiovascular events in these patients is mainly due to early atherosclerosis per se (increasing of all stiffness parameters) or to persistent inflammation, which could contribute to the atherosclerotic process through the maintenance of endothelial dysfunction. Indeed, IBD patients are carriers of a significant inflammatory background, as shown by altered level of CRP, and the pivotal role of inflammation in the onset of atherosclerosis has been confirmed by previous studies, and has been also correlated with the level of proinflammatory cytokines [36,37]. In addition, it has been also reported that high levels of such cytokines, selectins and adhesion molecules were strongly related to the "markers" of arterial stiffness in patients suffering from cerebrovascular events [37,38].…”

“…On the basis of the collected data, an averaged radial pressure waveform was generated and a corresponding aortic pressure waveform and blood pressure calculated by the validated transfer function. The aortic pressure waveform was used to calculate the Aortic AIx (difference in height between the first (P1) and second (P2) systolic peaks expressed as a percentage of pulse pressure (PP) [36]). …”

Diabetic foot syndrome: Immune-inflammatory features as possible cardiovascular markers in diabetes

“…Thus inflammation marker evaluation has in DFS multiple points of potential importance concerning a better evaluation and analysis of these crucial key points: (1) pathogenetic role in ulcers and their micro and macrovascular background; (2)possible link between inflammation state and adipo-metabolic axis; (3) predictive role towards foot complications such as ulcers incidence; (4) putative role as markers of gravity of wounds and ulcers in a diabetic foot; (5) association with cardiovascular co-morbidity (prevalent and incident) in subjects with DFS; (6) prognostic role towards ulcer healing; (7) strict association with peripheral artery comorbidity (PAD); and (8) pathogentic links with metabolic syndrome and NASH [93][94][95][96][97][98][99] . It explains that a strict and prospective inflammation marker evaluation could be useful in practical management of foot complications in diabetic subjects in every medical setting (Internal Medicine, Diabetology, Surgery, Orthopedics) to better evaluate a complex disease such as DFS in a multispecialistic management contest.…”

New insights about the putative role of myokines in the context of cardiac rehabilitation and secondary cardiovascular prevention

“…The level of systemic inflammation in stroke patients strongly depends on the diagnostic subtype of stroke and is directly related to the extent of the neurological damage during the acute phase and to the residual disability (95)(96)(97)(98)(99)(100)(101).…”