Abstract | BACKGROUND AND PURPOSE: METHODS: Of a total of 94 consecutive patients with symptomatic intracranial stenoses, 40 fulfilled all inclusion criteria. Intracranial stenoses were confirmed by magnetic resonance angiography. Magnetic resonance imaging (MRI) including diffusion-weighted sequences was conducted. Plasmatic VEGF and endostatin were determined from blood samples obtained 3 months after stroke onset, and patients were followed-up thereafter. RESULTS: A total of 144 intracranial stenoses were confirmed (median number per patient=3). Endostatin/ VEGF ratio gradually augmented with the increasing number of intracranial stenoses (r=0.35, P=0.02). Diabetes mellitus (OR, 6.04; CI, 1.1 to 32.2; P=0.03) and a higher endostatin/ VEGF ratio (OR, 15.7; CI, 2.2 to 112.3; P=0.006) were independently associated with a greater extent of intracranial atherosclerosis. During a median follow-up of 13 months, 8 patients (20%) experienced a new cerebral ischemic event. A higher baseline endostatin concentration was an independent predictor of new events (hazard ratio, 7.24; CI, 1.6 to 33.8; P=0.011) in a Cox regression model after adjustment for age, sex, number of stenotic vessels, and risk factors. Patients with a higher endostatin level had a lower survival free of new events (P=0.01, log-rank test). CONCLUSIONS: A predominance of the inhibitor endostatin within the endogenous angiogenic response is associated with a greater extent and risk of recurrence of symptomatic intracranial atherosclerosis, suggesting that angiogenesis may be beneficial in this condition.
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Authors | Juan F Arenillas, José Alvarez-Sabín, Joan Montaner, Anna Rosell, Carlos A Molina, Alex Rovira, Marc Ribó, Esther Sánchez, Manuel Quintana |
Journal | Stroke
(Stroke)
Vol. 36
Issue 1
Pg. 92-7
(Jan 2005)
ISSN: 1524-4628 [Electronic] United States |
PMID | 15550686
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Endostatins
- Vascular Endothelial Growth Factor A
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Topics |
- Aged
- Brain Ischemia
(epidemiology)
- Disease-Free Survival
- Endostatins
(blood)
- Female
- Follow-Up Studies
- Humans
- Intracranial Arteriosclerosis
(diagnosis)
- Magnetic Resonance Imaging
- Male
- Neovascularization, Physiologic
- Prospective Studies
- Recurrence
- Risk Factors
- Vascular Endothelial Growth Factor A
(blood)
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