title: Association between changes in lipid profiles and progression of symptomatic intracranial atherosclerotic stenosis: a prospective multicenter study.
abstract: OBJECTIVE
  Predictors of progression of intracranial atherosclerotic stenosis have not been clearly identified. We investigated whether poststroke changes in lipid profiles would affect the prognosis of symptomatic intracranial atherosclerotic stenosis.
  
  
  METHODS
  This is a substudy of Trial of cilOstazol in Symptomatic intracranial Stenosis 2 (TOSS-2). From 10 centers we enrolled 230 subjects with acute symptomatic stenosis in the M1 segment of the middle cerebral artery or basilar artery. At baseline and 7 months after stroke, subjects underwent MR angiogram and assessment of cardiovascular risk factors including lipoprotein levels. Progression of intracranial atherosclerotic stenosis was determined by comparing stenosis on the baseline and follow-up MR angiograms.
  
  
  RESULTS
  Cilostazol treatment was more frequently seen in the nonprogression group (109 of 198 [55.1%]) than in the progression group (11 of 32 [34.4%]). At 7 months after stroke when compared with baseline, low-density lipoprotein cholesterol and total cholesterol levels decreased in both groups. However, only nonprogressors showed increase in high-density lipoprotein cholesterol levels between baseline and follow-up. Changes in apolipoprotein B/apolipoprotein A-I levels were not different between the groups, although apolipoprotein B/A-I at 7 months was higher in progressors than in nonprogressors. Remnant lipoprotein cholesterol levels decreased in nonprogressors, whereas they did not change in progressors. In multivariable analyses, after adjusting for cilostazol treatment and remnant lipoprotein cholesterol reduction or apolipoprotein B/A-I at 7 months, high-density lipoprotein cholesterol elevation remained as a significant predictor for the nonprogression.
  
  
  CONCLUSIONS
  This is the first prospective multicenter study to demonstrate that high-density lipoprotein cholesterol elevation, along with remnant lipoprotein cholesterol reduction and low apolipoprotein B/A-I, is associated with prevention of angiographic progression of symptomatic intracranial atherosclerotic stenosis.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT00130039.
authors.affiliation: Department of Neurology, Dongguk University College of Medicine, Dongguk University Ilsan Hospital, 814 Siksa-dong, Goyang, Korea, 410-773. kdongeog@duih.org
authors.forename: Dong-Eog
authors.initials: DE
authors.lastname: Kim
authors.forename: Jeong-Yeon
authors.initials: JY
authors.lastname: Kim
authors.forename: Sang-Wuk
authors.initials: SW
authors.lastname: Jeong
authors.forename: Yong-Jin
authors.initials: YJ
authors.lastname: Cho
authors.forename: Jong-Moo
authors.initials: JM
authors.lastname: Park
authors.forename: Ju-Hun
authors.initials: JH
authors.lastname: Lee
authors.forename: Dong-Wha
authors.initials: DW
authors.lastname: Kang
authors.forename: Kyung-Ho
authors.initials: KH
authors.lastname: Yu
authors.forename: Hee-Joon
authors.initials: HJ
authors.lastname: Bae
authors.forename: Keun-Sik
authors.initials: KS
authors.lastname: Hong
authors.forename: Ja-Seong
authors.initials: JS
authors.lastname: Koo
authors.forename: Seung-Hoon
authors.initials: SH
authors.lastname: Lee
authors.forename: Byung-Chul
authors.initials: BC
authors.lastname: Lee
authors.forename: Moon-Ku
authors.initials: MK
authors.lastname: Han
authors.forename: Joung-Ho
authors.initials: JH
authors.lastname: Rha
authors.forename: Yong-Seok
authors.initials: YS
authors.lastname: Lee
authors.forename: Gyeong-Moon
authors.initials: GM
authors.lastname: Kim
authors.forename: Seok-Lae
authors.initials: SL
authors.lastname: Chae
authors.forename: Jong S
authors.initials: JS
authors.lastname: Kim
authors.forename: Sun U
authors.initials: SU
authors.lastname: Kwon
mesh_terms: D000368:Aged; D016893:Carotid Stenosis / Q000097:blood* / Q000473:pathology*; D018450:Disease Progression; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000097:blood* / Q000473:pathology*; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D008055:Lipids