title: Elevated hemoglobin A1c Is Associated with Carotid Plaque Vulnerability: Novel Findings from Magnetic Resonance Imaging Study in Hypertensive Stroke Patients.
abstract: The association between hemoglobin A1c (HbA1c) level and carotid plaque vulnerability has been rarely studied by magnetic resonance imaging (MRI). The present study of MRI-identified carotid atherosclerotic lesions in hypertensive patients with acute stroke therefore sought to determine the associations between HbA1c level and plaque morphological and compositional characteristics and acute cerebral infarction (ACI) severity. Eighty hypertensive patients with acute stroke were enrolled; stratified into high (≥6.5%) and low (<6.5%) HbA1c groups; and underwent carotid and brain MRI to assess carotid plaque features and ACI volume in the region supplied by the internal carotid artery (ICA) in the symptomatic side. Plaque burden [percent wall volume (PWV), max wall thickness (max-WT)] and lipid-rich necrotic core (LRNC) were larger in the high as compared to the low HbA1c group. High HbA1c was an independent risk factor for the presence of plaque (odds ratio [OR] = 3.71) and LRNC plaque (OR = 7.08). HbA1c independently correlated with ACI severity among patients with ICA region cerebral infarction and carotid plaque. Our study suggested that an elevated HbA1c may have an adverse effect on carotid plaque vulnerability especially those with larger LRNC volumes in hypertensive stroke patients, which might exacerbate the severity of ACIs.
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, China.
authors.forename: Beibei
authors.initials: B
authors.lastname: Sun
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, China.
authors.forename: Huilin
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, China.
authors.forename: Xiaosheng
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Lu
authors.affiliation: Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China.
authors.forename: Xihai
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Pu
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, China.
authors.forename: Jianrong
authors.initials: J
authors.lastname: Xu
mesh_terms: D000368:Aged; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D002544:Cerebral Infarction / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D058225:Plaque, Amyloid / Q000473:pathology; D058226:Plaque, Atherosclerotic / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology; D012307:Risk Factors; D020521:Stroke / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology
chemical_list: D006442:Glycated Hemoglobin