title: Stroke with polyvascular atherothrombotic disease.
abstract: OBJECTIVE
  To study the influence of polyvascular atherothrombotic disease on stroke patient prognosis, its relation with inflammatory markers, and to analyze the progression of atherothrombotic disease.
  
  
  METHODS
  MITICO is a multi-centered prospective observational study recruiting non-anticoagulated ischemic stroke patients. Blood samples were obtained at baseline and at one year follow-up for determination of high sensitivity C reactive protein (hs-CRP), interleukin 6 (IL-6), intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), matrix metalloproteinase 9 (MMP-9), and cellular fibronectin (c-Fn). Patients with polyvascular atherothrombotic disease were considered when presented a history of angina-myocardial infarction, intermittent claudication or ischemic limbs-amputation at inclusion.
  
  
  RESULTS
  The sample consisted of 863 patients, 121 of them considered as polyvascular atherothrombotic disease (14.02%). Recurrence and vascular death were higher in patients with polyvascular atherothrombotic disease, as compared to patients with monovascular atherothrombotic disease (19.8% vs. 12.4%, p=0.022). Baseline plasma levels of IL-6 and VCAM-1 were higher in patients with polyvascular atherothrombotic disease. IL-6 and VCAM-1 levels were independently associated with a new vascular episode/vascular death. This association was stronger in the group of patients with polyvascular atherothrombotic disease. Baseline levels of IL-6, VCAM-1 and c-Fn were significantly higher in patients who developed progression of atherothrombotic disease. The increase from baseline in MMP-9 and c-Fn levels after one year follow-up was associated to progression of atherothrombotic disease.
  
  
  CONCLUSIONS
  Stroke patients with polyvascular atherothrombotic disease showed higher rates of vascular recurrence and a stronger association with inflammatory markers. Progression of atherothrombotic disease was associated with inflammatory markers.
authors.affiliation: Department of Neurology, Clinical Neuroscience Research Laboratory, Hospital Clínico Universitario, Universidad de Santiago de Compostela, Travesa da Choupana s/n, 15706 Santiago de Compostela, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Blanco
authors.forename: Tomás
authors.initials: T
authors.lastname: Sobrino
authors.forename: Joan
authors.initials: J
authors.lastname: Montaner
authors.forename: Vicente
authors.initials: V
authors.lastname: Medrano
authors.forename: Carmen
authors.initials: C
authors.lastname: Jiménez
authors.forename: Jaime
authors.initials: J
authors.lastname: Masjuán
authors.forename: Carlos
authors.initials: C
authors.lastname: Gómez-Escalonilla
authors.forename: Pilar
authors.initials: P
authors.lastname: de Luis
authors.forename: Adriá
authors.initials: A
authors.lastname: Arboix
authors.forename: José
authors.initials: J
authors.lastname: Castillo
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000473:pathology; D000925:Anticoagulants / Q000494:pharmacology; D001158:Arteries / Q000473:pathology*; D002545:Brain Ischemia / Q000473:pathology; D002318:Cardiovascular Diseases / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies; D020521:Stroke / Q000150:complications*; D013927:Thrombosis / Q000150:complications*
chemical_list: D000925:Anticoagulants