title: Deep subcortical infarct burden in relation to apolipoprotein B/AI ratio in patients with intracranial atherosclerotic stenosis.
abstract: OBJECTIVE
  Pre-existing brain infarct (PBI), frequently seen on magnetic resonance imaging and usually silent, is recognized as a risk factor for future stroke. Increased apolipoprotein B (apoB)/apoAI ratio is known to be a risk predictor of ischaemic stroke and is associated with intracranial atherosclerotic stenosis (ICAS). However, little is known about the association of apoB/apoAI ratio with PBI.
  
  
  METHODS
  A total of 522 statin-/fibrate-naïve Korean patients, who experienced acute ischaemic stroke, were categorized into three groups: ICAS (n=254), extracranial (n=51), and no cerebral atherosclerotic stenosis (n=217). We explored the association between apoB/apoAI ratio and PBI lesions according to atherosclerosis type (ICAS, ECAS, and NCAS), PBI location (deep subcortical [ds-PBI] versus hemispheric [h-PBI]), and symptomatic PBI (s-PBI) which was relevant to a prior clinical stroke event.
  
  
  RESULTS
  Pre-existing brain infarct(+) patients showed a higher apoB/apoAI ratio than PBI(-) patients (0.81 ± 0.28 vs. 0.72 ± 0.23, P<0.001). In ICAS group, patients with higher apoB/apoAI ratio quartiles had more PBIs, ds-PBIs, and s-PBIs (P=0.020, P=0.025, and P=0.001, respectively). With multivariable analyses, the highest apoB/apoAI ratio quartile was associated with PBI (OR, 2.56; 95% CI, 1.39-4.73), ds-PBI (2.48; 1.33-4.62), and advanced (≥ 3) ds-PBIs (2.68; 1.27-5.63) in ICAS group, but not with h-PBI. s-PBI had a dose-response relationship with apoB/apoAI ratio quartiles (6.18; 1.31-29.13 for the second; 5.34; 1.06-26.83 for the third; and 12.17; 2.50-59.19 for the fourth quartile), when referenced to the first quartile.
  
  
  CONCLUSIONS
  ApoB/apoAI ratio is associated with asymptomatic deep subcortical ischaemic burden as well as with symptomatic lesion in patients with ICAS.
authors.affiliation: Department of Neurology, Kwandong University Myongji Hospital, Goyang, Korea. neurocraft@kd.ac.kr
authors.forename: J-H
authors.initials: JH
authors.lastname: Park
authors.forename: K-S
authors.initials: KS
authors.lastname: Hong
authors.forename: J
authors.initials: J
authors.lastname: Lee
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Kim
authors.forename: P
authors.initials: P
authors.lastname: Song
mesh_terms: D000208:Acute Disease; D000368:Aged; D016632:Apolipoprotein A-I / Q000097:blood* / Q000235:genetics; D001055:Apolipoproteins B / Q000097:blood* / Q000235:genetics; D020520:Brain Infarction / Q000097:blood / Q000235:genetics / Q000473:pathology*; D002545:Brain Ischemia / Q000473:pathology; D002533:Cerebral Angiography; D003251:Constriction, Pathologic; D005260:Female; D018628:Gene Dosage; D006801:Humans; D007091:Image Processing, Computer-Assisted; D002537:Intracranial Arteriosclerosis / Q000097:blood / Q000235:genetics / Q000473:pathology*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000235:genetics / Q000473:pathology
chemical_list: D016632:Apolipoprotein A-I; D001055:Apolipoproteins B