Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"Screening prediction models using artificial intelligence for moderate-to-severe obstructive sleep apnea in patients with acute ischemic stroke.","authors":"Huan-Jan Lin, Tian-Hsiang Huang, Hui-Ci Huang, Pao-Li Hsiao, Wen-Hsien Ho","doi":"10.1016/j.jstrokecerebrovasdis.2024.108214","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.108214","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is common after stroke. Still, routine screening of OSA with polysomnography (PSG) is often unfeasible in clinical practice, primarily because of how limited resources are and the physical condition of patients. In this study, we used several artificial intelligence techniques to predict moderate-to-severe OSA and identify its features in patients with acute ischemic stroke.</p><p><strong>Methods: </strong>A total of 146 patients with acute ischemic stroke underwent PSG screening for OSA. Their baseline demographic characteristics, including age, sex, body mass index (BMI), Epworth Sleepiness Scale (ESS) score, and stroke risk factors, were recorded. Logistic regression analysis was conducted to identify significant features associated with moderate-to-severe OSA in patients with stroke. These significant features were used with six machine learning and ensemble learning algorithms, namely decision tree, support vector machine, random forest, extreme gradient boosting (XGBoost), adaptive boosting (AdaBoost), and gradient boosting, to compare the performance of several predictive models.</p><p><strong>Results: </strong>Multivariate logistic regression analysis revealed that age, sex, BMI, neck circumference, and ESS score were significantly associated with the presence of moderate-to-severe OSA. According to the machine learning and ensemble learning results, the XGBoost model achieved the highest performance, with an area under the receiver operating characteristic curve of 0.89 and an accuracy and F1 score of 0.80.</p><p><strong>Conclusion: </strong>This study identified key factors contributing to moderate-to-severe OSA in patients with ischemic stroke. The XGBoost model exhibited high predictive performance, indicating it has potential as a supporting tool for decision-making in health-care settings.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 2","pages":"108214"},"PeriodicalIF":2.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review and meta-analysis of audits measuring antithrombotic therapy within forty-eight hours for ischemic stroke.","authors":"Andy Lim, Grace Phillips, Warren Chan, Shams Albrefkany, Jeniffer Kim-Blackmore, Henry Ma, Thanh Phan","doi":"10.1016/j.jstrokecerebrovasdis.2024.108213","DOIUrl":"https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.108213","url":null,"abstract":"<p><strong>Background: </strong>Meta-analysis of clinical trials supports the use of early antithrombotic medication in ischemic stroke and transient ischemic attack. It is not known whether this therapy is delivered within the 85 % threshold that is acceptable in North America's Get With The Guidelines stroke program.</p><p><strong>Aim: </strong>to investigate the pooled proportion of patients receiving antiplatelet therapy within 48 h of ischemic stroke.</p><p><strong>Methods: </strong>PubMed to November 2022 was searched for studies reporting \"stroke\", \"audit\", \"antithrombotic\", \"national\" and \"registry\". Multilevel random effects meta-analysis was used to cluster studies by country.</p><p><strong>Results: </strong>There were 45 studies describing 1,178,595 patients. The pooled proportion of patients receiving antithrombotic therapy within 48 h was 81.1 %, (95 % CI 74.5, 87.8, p < 0.0001, I²=99.99 %). The high heterogeneity was due to within-country (I²_{Level 3} = 55.4 %) and between-country heterogeneity (I²_{Level 2} = 44.6 %). There was no statistical significance (p = 0.35) between low- to middle- income countries (LMIC) - 81.8 %, (95 % CI 76.1, 87.4, p < 0.01, I²=100 %) and high-income countries (HIC) - 86.8 %, (95 % CI 81.2, 92.3, p < 0.01, I²=99.7 %) nor any difference between contemporary studies (2008 and later) - 86.5 %, (95 % CI 82.3, 90.8, p < 0.01, I²=100 %) - and studies published before 2008 - 69.9 %, (95 % CI 57.4, 82.4, p < 0.01, I²=99.7 %). Sensitivity analysis showed no difference when excluding single centre studies, observations with n < 500, or both. Meta-regression showed proportion of antiplatelet administration at 48 h to increase significantly with subsequent year of publication (β=0.01, 95 % CI 0.00, 0.02, p < 0.05).</p><p><strong>Conclusion: </strong>Our key finding is that the majority of countries do not yet provide early antiplatelet therapy at a level acceptable by Get With The Guidelines hospitals.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 2","pages":"108213"},"PeriodicalIF":2.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of multicomponent rehabilitation exercise plus soymilk on cognitive impairment and ischemic lesion growth in stroke patients: A randomized controlled trial.","authors":"Babak Esmealy, Leyla Esmealy, Leila Gholizadeh, Saeid Nikookheslat, Vahid Sari-Sarraf","doi":"10.1016/j.jstrokecerebrovasdis.2024.108207","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108207","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to examine the effects of a multicomponent rehabilitation exercise, coupled with soymilk intake post-exercise, on cognitive impairment and ischemic lesion growth among acute stroke patients.</p><p><strong>Methods: </strong>In a four-arm, single-blind, randomized clinical trial, 120 patients with acute stroke were randomly allocated to one of the following groups: 1) the MRE + soymilk, 2) the MRE, 3) the soymilk, and 4) the control group. Each group underwent their respective intervention for a continuous duration of 20 days. Cognitive impairment was assessed using the Montreal Cognitive Assessment, and the growth of ischemic lesions was evaluated through CT scans.</p><p><strong>Results: </strong>The MRE combined with soymilk intervention demonstrated statistically significant improvements in cognitive impairment among acute stroke patients (χ² = 51.055, p = 0.000). Group differences began to emerge from Week, with improvements observed across all dimensions of cognitive function, except for abstraction. No significant differences were observed between groups in terms of ischemic lesion growth (χ² =0.934, p = 0.810).</p><p><strong>Conclusion: </strong>The incorporation of a multicomponent rehabilitation exercise combined with soymilk ingestion demonstrated effectiveness in alleviating cognitive impairment among acute stroke patients. Nevertheless, it did not influence the growth of ischemic lesions.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108207"},"PeriodicalIF":2.0,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral collateral flow state in acute ischemic stroke correlates with clinical functional outcomes in non-thrombectomy patients.","authors":"Smit Shah, Stefanie Wood, Lawson Logue, Jaclyn Meyer, Karly Pikel, Matthew Germroth, Gowri Peethamber, Nishanth Kodumuri, Forrest Justin Lowe, Ravish Kothari, Line Rahman, Swamy Venkatesh, Souvik Sen","doi":"10.1016/j.jstrokecerebrovasdis.2024.108211","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108211","url":null,"abstract":"<p><strong>Introduction: </strong>Hypoperfusion index ratio (HIR) measured by computerized tomography perfusion (CTP) has been shown to predict collateral flow state in acute ischemic stroke (AIS). Low HIR (<0.4) is indicative of good collateral flow state. This study tested the association between good collateral flow state and stroke severity and clinical outcome at discharge.</p><p><strong>Methods: </strong>Data from AIS patients who underwent CTP during initial stroke evaluation were linked with Get With the Guideline database between 2018 and 2020. Patients with good collateral flow (HIR < 0.4) were compared to those with poor collateral flow (≥0.4). They were stratified based on modified Rankin Score (mRS) at discharge into good (mRS 0-2) or poor (mRS 3-6) outcomes. A collateral score of 0-3 was assigned using CTA's obtained at the time of AIS presentation. We used univariate and multivariable logistic regression analyses to test the association between good collateral flow state and good discharge outcome.</p><p><strong>Results: </strong>CT perfusion data was obtained in 1442 patients. After exclusions, 391 patients (age 69 ± 14, 54% male, 48% white, 52% black/others) remained, of whom 295 (75%) demonstrated good collateral flow and 96 (25%) showed poor collateral flow. Those with good collateral flow were younger (69 ± 14 vs. 71 ± 15, p = 0.25) and lower median NIHSS [7 (25-75%ile 3-13) vs. 14 (25-75%ile 8-20), p < 0.001]. CTA collateral scores demonstrated a significant inverse correlation to HIR. Good collateral flow was associated with good outcome on discharge (OR 2.7, 95% CI 1.4-5.1). The association remained significant after adjustment for demographics and comorbidities (adjusted OR 3.2 (1.7-6.4).</p><p><strong>Conclusions: </strong>In patients presenting with AIS who were non-thrombectomy candidates, good collateral flow state measured by HIR on CTP was associated with good functional outcome at discharge after adjustment for comorbidities.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108211"},"PeriodicalIF":2.0,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular thrombectomy for acute ischemic stroke with primary occlusion of the anterior cerebral artery: A meta-analysis.","authors":"Shovan Bhatia, Sirisha T Nouduri, Akshay Sankar, Michael R Kann, Angela Hardi, Joseph S Hudson, Alhamza R Al-Bayati, Raul G Nogueira, Michael J Lang, Bradley A Gross","doi":"10.1016/j.jstrokecerebrovasdis.2024.108208","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108208","url":null,"abstract":"<p><strong>Background: </strong>Anterior cerebral artery (ACA) occlusions account for up to 4 % of all acute ischemic strokes and may lead to debilitating outcomes. While endovascular thrombectomy (EVT) is a well-established treatment for large vessel occlusions, its efficacy and safety for primary ACA occlusions remains unclear. This systematic review and meta-analysis aims to address this gap by evaluating the clinical outcomes, safety, and efficacy of EVT in the treatment for primary ACA occlusions.</p><p><strong>Methods: </strong>Following PRISMA guidelines, five databases were queried from database inception until April 2024 for studies describing the use of EVT for acute ischemic primary ACA occlusions. Following abstract, title, and full text-screening, data on patient demographics, clinical presentation, procedural details, and surgical outcomes were extracted from included articles. Primary outcomes were successful reperfusion (modified-Treatment in Cerebral Infarction (mTICI) score 2b-3), and favorable functional outcomes (3-month modified Rankin Scale (mRS) scores 0-2). Secondary outcomes included 3-month mortality rates and procedural complication rates. Meta-analysis was performed using a random-effects model, with heterogeneity assessed by the Higgins index (I²>50 %).</p><p><strong>Results: </strong>Ten studies met eligibility criteria, encompassing a total of 265 patients with complete clinical and outcome data. Across the pooled meta-analysis, the rate of successful reperfusion (mTICI ≥ 2b) was 0.78 (95 % CI: 0.67-0.86) and the rate of 3-month mRS score 0-2 was 0.41 (95 % CI: 0.33-0.51). Pooled meta-analysis of secondary outcomes analysis revealed a 3-month mortality rate of 0.20 (95 % CI: 0.15-0.26), while the rate of symptomatic intracerebral hemorrhage was 0.04 (95 % CI: 0.02-0.08).</p><p><strong>Conclusion: </strong>Our findings demonstrate that while successful reperfusion can be achieved with low complication rates, primary ACA occlusions treated with EVT are associated with high morbidity and mortality.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108208"},"PeriodicalIF":2.0,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut microbiota and hemorrhagic stroke: Emerging insights and future perspectives.","authors":"Chenyang Zang, Zheng Xiao, Luo Zhou","doi":"10.1016/j.jstrokecerebrovasdis.2024.108212","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108212","url":null,"abstract":"","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108212"},"PeriodicalIF":2.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the association between the TyG-WHtR index and the incidence of stroke in the obese population: based on NHANES data from 1998 to 2018.","authors":"Liyan Fu, Qingxuan Xing, Xiaoqian Wang, Yaoyao Chen, Jingjing Kong, Jin Li, Baohong Yue","doi":"10.1016/j.jstrokecerebrovasdis.2024.108209","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108209","url":null,"abstract":"<p><strong>Background: </strong>The TyG index is an emerging low-cost and efficient indicator that is significantly associated with stroke. Multiple studies have confirmed the impact of the TyG index on cerebrovascular diseases. However, the role of indices combining TyG with different obesity factors, such as triglyceride glucose-waist-height ratio (TyG-WHtR) on stroke risk in obese individuals remains unclear. This study utilizes data from the National Health and Nutrition Examination Survey database between 1998 and 2018 to explore the relationship between stroke and the TyG-WHtR index in obese individuals.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from 5767 obese individuals from the NHANES database between 1998 and 2018. Univariate and multivariate logistic regression analyses were used to study the association between TyG-WHtR and stroke, utilizing continuous variables or categorizing variables based on quartiles. Propensity score matching (PSM) and subgroup analysis stratifying characteristics of TyG-WHtR and stroke were further conducted to study their relationship. Additionally, restricted cubic spline (RCS) analysis was performed to examine the linear relationship between TyG-WHtR and stroke.</p><p><strong>Results: </strong>A total of 5767 participants were included in the statistical analysis, comprising 227 stroke patients and 5540 non-stroke participants. Multivariable logistic regression analysis revealed a positive association between TyG-WHtR and stroke both before and after matching (P < 0.001), with statistically significant differences. Subgroup analysis indicated a statistically significant difference among non-Hispanic white individuals, and RCS analysis showed a non-linear relationship between TyG-WHtR and stroke before matching, but a linear relationship after matching.</p><p><strong>Conclusion: </strong>In obese individuals, a higher TyG-WHtR index is positively associated with stroke risk.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108209"},"PeriodicalIF":2.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic study of intracranial branch atheromatous disease in the blood-supplying areas of the lenticulostriate and paramedian pontine arteries.","authors":"Yang Liu, Lihua Wang, Kuang Fu, Xiaotong Kong, Wenhui Guo, Ning Wang, Xuesong Sun, Hanlu Cai, Yan Yu, Zhaobo Zhang, Xingbang Zou, Ying Cao, Doudou Luo, Peifang Liu","doi":"10.1016/j.jstrokecerebrovasdis.2024.108210","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108210","url":null,"abstract":"<p><strong>Introduction: </strong>Branch atheromatous disease (BAD) is prone to early neurological deterioration (END), leading to a poor prognosis. The most common arteries causing END are the lenticulostriate arteries (LSA) and the paramedian pontine arteries (PPA). To gain insight into the characteristics of symptomatic plaques and their association with poor prognosis in patients with BAD, we conducted a prospective study using high-resolution magnetic resonance imaging (HRMRI).</p><p><strong>Methods: </strong>A total of 75 patients with BAD in the vascular range of LSA or PPA were recruited for this study. The vascular and plaque features of the carrier middle cerebral artery (MCA) and basilar artery (BA) were evaluated through the application of HRMRI, and the local cerebral blood flow (CBF) of the lesion was assessed through pseudo-continuous arterial spin-labeling (pCASL), and the number and location of cerebral microbleeds (CMBs) were documented by susceptibility-weighted imaging (SWI). Univariable and multivariable logistic regression analyses were performed to analyze the factors that affected the prognosis.</p><p><strong>Results: </strong>A poor prognosis was observed in 24 patients (32%) with BAD. A total of 28 patients (37%) developed END. Multifactorial analysis showed statistically significant differences in the dorsal plaque of BA (OR: 19.15, 95% CI 1.72-385.37, p=0.028), male (OR: 26.22, 95% CI 3.18-406.31, p=0.007), and NIHSS at 7 days of onset (OR: 2.24, 95% CI 1.4-4.45, p=0.004).</p><p><strong>Conclusions: </strong>In patients with BAD in LSA and PPA areas, the dorsal plaque of BA, male, and NIHSS at 7 days of onset were independent risk factors for poor prognosis.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108210"},"PeriodicalIF":2.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of early antihypertensive treatment on cognitive function in patients with acute ischemic stroke with different neurofilament light chain levels.","authors":"Hong Li, Deyu Yang, Shudong Liu, Zhengbao Zhu, Mengyao Shi, Tan Xu, Jing Chen, Yonghong Zhang, Jiang He, Chongke Zhong, Xiaoqing Bu","doi":"10.1016/j.jstrokecerebrovasdis.2024.108206","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108206","url":null,"abstract":"<p><strong>Background: </strong>It is unclear whether the extent of neuroaxonal damage, as measured by circulating levels of neurofilament light chain (NfL), would modify the effects of early antihypertensive therapy on cognitive performance following stroke. This study aimed to investigate the effects of early blood pressure reduction on the risk of post-stroke cognitive impairment (PSCI) among patients with different plasma NfL levels.</p><p><strong>Methods: </strong>A total of 622 eligible patients from a pre-planned ancillary study of CATIS (China Antihypertensive Trial in Acute Ischemic Stroke) were included in this study. The electrochemiluminescence immunoassay technique was used to evaluate Plasma NfL levels at baseline, and the Mini-Mental State Examination (MMSE) in Chinese was used to assess cognition at the 3-month follow-up. An MMSE score of less than 27 was considered as PSCI.</p><p><strong>Results: </strong>The effect of antihypertensive therapy on PSCI differed according to NfL levels at the 3-month follow-up. In the low NfL group, compared with the control group, antihypertensive treatment reduced the risk of PSCI [adjusted odds ratio (OR), 95 % confidence interval (CI): 0.50 (0.31-0.81)]. However, in the high NfL group, antihypertensive treatment increased the risk of PSCI compared with the control group [adjusted OR, 95 % CI: 1.93 (1.16-3.20)].</p><p><strong>Conclusions: </strong>Antihypertensive therapy in the acute phase reduced the risk of PSCI in patients with low plasma NfL levels, but increased the risk in patients with high NfL levels.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108206"},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mendelian randomization and mediation examination of the immune cell-mediated link between sphingomyelin and stroke.","authors":"Cong Xu, Yonghong Xu, Jianglei Ma, Guangming Wang","doi":"10.1016/j.jstrokecerebrovasdis.2024.108205","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108205","url":null,"abstract":"<p><strong>Objective: </strong>The study established a direct link between stroke and sphingomyelin. The precise biology underlying this connection is yet unknown, though. As a result, we decided to investigate the potential causal relationship between Sphingomyelin and genetic vulnerability to stroke, as well as the potential mediating function that immune cells may play in this process, using Mendelian randomization (MR) approaches.</p><p><strong>Methods: </strong>A published genome-wide association study (GWAS) dataset of European populations served as the foundation for the MR Study. The inverse variance weighting (IVW) model is the main technique. Four additional statistical techniques (MR Egger, Weighted median, Simple mode, and Weighted mode) were also employed to enhance the verification process. Reverse MR Analysis was utilized to reinforce the findings, and heterogeneity and horizontal pleipotency were assessed. Additionally, this study looked into potential immune cell mediating roles in the causal link between sphingomyelin and stroke using two-step MR techniques.</p><p><strong>Result: </strong>The IVW metod's results indicated that sphingomyelin genetic susceptibility was linked to a high risk of stroke (OR = 1.045 [95 %CI, 1.004-1.087; P = 0.031). Additionally, the statistical result of SSC-A on CD8br and stroke was IVW [P = 0.007, OR(95 % CI) 1.020 (1.005-1.034)], which was proportionate to the increased risk of stroke. A lower incidence of stroke IVW is linked to CD45 on CD8br [P = 0.004, OR(95 % CI) 0.993 (0.988-0.998)]. Furthermore, our results imply that SSC-A on CD8br and CD45 on CD8br contribute to the causative relationship between sphingomyelin and stroke. The percentages of conciliation are 5.38 %, 22.7 %, 33.5 %), and 0.000999, 0.0152, 0.0132, respectively.</p><p><strong>Conclusion: </strong>We confirmed the effect of sphingomyelin on stroke and conducted in-depth studies. SSC-A on CD8br and CD45 on CD8br is latent stroke mediators associated with sphingomyelin. Through two-step mediated Mendelian randomization analysis, we provide new insights into the etiology and treatment of stroke.</p>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":" ","pages":"108205"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}