Plasma β-amyloid 1-40 is associated with the diffuse small vessel disease subtype

Meritxell Gomis, Tomás Sobrino, Angel Ois, Mònica Millán, Ana Rodríguez-Campello, Natalia Pérez De La Ossa, Raquel Rodríguez-González, Jordi Jiménez-Conde, Elisa Cuadrado-Godia, Jaume Roquer, Antoni Dávalos

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    41 Citations (Scopus)

    Abstract

    Background and Purpose-: The underlying mechanisms of small vessel disease (SVD) subtypes are diffuse arteriopathy (diffuse-SVD) or microatheroma (focal-SVD). Endothelial dysfunction by β-amyloid peptide (Aβ) deposition has been associated with lacunar infarcts and leukoaraiosis, but its specific relationship with SVD subtypes is unknown. We hypothesized that plasma Aβ levels can play a different role in SVD subtypes in patients with acute lacunar stroke. Methods-: We studied 149 patients with acute ischemic stroke of SVD etiology according to Trial Of Org 10172 In Acute Stroke Treatment criteria and 25 age-matched control subjects. Patients were classified into focal-SVD: 39 patients with isolated lacunar infarct without leukoaraiosis and diffuse-SVD: 110 patients with an isolated lacunar infarct with leukoaraiosis or with multiple lacunar infarcts with or without leukoaraiosis. Baseline data included vascular risk factors and extensive laboratory tests, including plasma Aβ levels. Results-: Median [quartiles] Aβ1-40 levels (40.4 [35.1, 50.5] versus 55.1 [42.3, 69.6] pg/mL), but not Aβ1-42 levels, were significantly higher in the diffuse-SVD group than in focal-SVD group (P<0.001) and control subjects (P<0.001). No differences in Aβ1-40 levels were found between focal-SVD and control subjects. Logistic regression analysis showed that age (OR, 1.06; 95% CI, 1.01 to 1.12), history of hypertension (OR, 3.5; 95% CI, 1.3 to 9.2), and plasma β-amyloid1-40 levels over the median value (OR, 17.3; 95% CI, 3.0 to 99 for the third quartile and OR, 6.0; 95% CI, 1.6 to 23 for the fourth quartile) were independently associated with the diffuse-SVD subtype. Conclusions-: Plasma β-amyloid1-40 levels are independently associated with the diffuse-SVD subtype. These Results are consistent with the pathophysiological role of fraction Aβ1-40 in disrupting endothelial vascular function. © 2009 American Heart Association, Inc.
    Original languageEnglish
    Pages (from-to)3197-3201
    JournalStroke
    Volume40
    Issue number10
    DOIs
    Publication statusPublished - 1 Oct 2009

    Keywords

    • Acute stroke
    • Beta-amyloid protein
    • Leukoaraiosis
    • Small vessel disease

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