Biochemical risk factors in angiographically established stenosis of cerebral arteries.
OBJECTIVE
To determine the significance of the association between biochemical risk factors for cerebrovascular atherosclerosis (lipid parameters, lipoprotein(a), total homocysteine, total antioxidant status, trace elements, and electrolytes) and the degree of stenosis of cerebral arteries scored by digital subtraction angiography.


METHODS
The study included 35 patients with angiographically established < 50% stenosis of cerebral arteries and 55 patients with > or =50% stenosis of cerebral arteries, including obliteration. The control group consisted of 51 patients with normal cerebral arteries on ultrasound examination. Biochemical parameters were measured in all participants according to the standard laboratory protocols.


RESULTS
Logistic regression analysis showed two independent and significant biochemical risk factors associated with the severity of cerebrovascular stenosis: lipoprotein(a) for patients with different degrees of stenosis, and total antioxidant status for patients with severe stenosis of more than 50%. Univariate statistical evaluation showed significantly higher homocysteine levels in the group of patients with > or =50% stenosis than in the control group (median 14.84 micromol/L vs median 12.40 micromol/L, p < 0.05).


CONCLUSIONS
Increased lipoprotein(a) and low total antioxidant status values seem to be the most significant independent biochemical risk factors for the development of cerebrovascular stenosis. Mild hyperhomocysteinemia seems to be an additional discriminating indicator of the severe cerebrovascular stenosis. These factors may be useful for early identification and recognition of patients with cerebrovascular atherosclerosis.
Vrhovski-Hebrang
Danijela
D
Department of Clinical Chemistry, Merkur University Hospital, Zagreb, Croatia. zlata.mestric@zg.hinet.hr
Flegar-Mestrić
Zlata
Z
Preden-Kereković
Vlatka
V
Perkov
Sonja
S
Hebrang
Andrija
A
Janus
Dragutin
D
Grga
Ante
A
D000328:Adult; D000368:Aged; D015415:Biomarkers; D016022:Case-Control Studies; D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000097:blood / Q000000981:diagnostic imaging; D002784:Cholesterol / Q000097:blood / Q000145:classification; D003251:Constriction, Pathologic / Q000097:blood* / Q000000981:diagnostic imaging; D017523:Croatia; D005260:Female; D006711:Homocystine / Q000097:blood*; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000097:blood* / Q000000981:diagnostic imaging; D017270:Lipoprotein(a) / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008670:Metals / Q000097:blood; D008875:Middle Aged; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D015415:Biomarkers; D017270:Lipoprotein(a); D008670:Metals; D014280:Triglycerides; D006711:Homocystine; D002784:Cholesterol