Association of elevated plasma viscosity with small vessel occlusion in ischemic cerebral disease.
BACKGROUND
Elevated plasma viscosity (PV) is observed in patients with vascular risk factors, such as diabetes mellitus or arterial hypertension. In this study we investigated the association of plasma viscosity and the different clinical and radiological entities of cerebral ischemia.


METHODS
PV of 465 consecutively admitted patients with clinical symptoms of acute cerebral ischemia without radiological signs of bleeding was measured. Data is expressed as median [range] unless stated otherwise. p<0.05 was considered statistically significant.


RESULTS
Patients with acute cerebral ischemia (TIA or Stroke) showed increased PV (TIA 1.27mPas [1.07-1.53], stroke 1.27mPas [1.07-1.56]) compared to patients without cerebral ischemia (Mimics) (1.23mPas [1.06-1.42]). The group with radiologically proven small vessel disease (SVD) had a significantly higher mean values of PV (1.29mPas [1.06-1.54]) compared to those with signs of large vessel disease or cardioembolic events (1.22mPas [1.07-1.56], p<0.001). Patients with chronic heart failure (p=0.007), arterial hypertension (p<0.001) and diabetes mellitus (p=0.002) had higher PV compared to patients without these cardiovascular risk factors. Hyperlipidemia or nicotine abuse showed no relation to PV.


CONCLUSIONS
Elevated PV is not only associated TIA and Stroke but is also found in patients with radiological signs of cerebral SVD. High levels of PV could be an underestimated risk for TIA and Stroke and participate in the complex pathophysiology of SVD. Prospective observational and interventional studies are warranted for further evaluation of PV in neurological ischemic diseases.
Saarland University, Department of Internal Medicine II, Kirrberger Str. 100, 66421 Homburg/Saar, Germany. Electronic address: katharina.grotemeyer@uks.eu.
Katharina C
KC
Grotemeyer
Department of Internal Medicine V, Saarland University, Germany.
Ralf
R
Kaiser
Department of Neu, Klinikum Saarbruecken, Germany.
Karl-Heinz
KH
Grotemeyer
Department of Neurology, University of Muenster, Germany.
Ingo W
IW
Husstedt
D000368:Aged; D003920:Diabetes Mellitus / Q000097:blood; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood; D006973:Hypertension / Q000097:blood; D002546:Ischemic Attack, Transient / Q000097:blood* / Q000473:pathology; D008297:Male; D012307:Risk Factors; D020521:Stroke / Q000097:blood* / Q000473:pathology; D014783:Viscosity
CCT; ECG; LVD; M. Binswanger; M. Binswanger/subcortical arterial encephalopathy; MRI; PV; Plasma viscosity; Risk factor; SAE; SVD; Small vessel disease; Stroke; TIA; cranial computer tomography; electro cardiogram; large vessel disease; mPas; magnet resonance imaging; milli-Pascal-second; plasma viscosity; small vessel disease; transitory ischemic attack