Predictive value of carotid atherosclerotic plaques assesment, in combination with glycosylated hemoglobin A1c and C-reactive protein levels, for disease progression in young patients with acute ischemic stroke.

Valor predictivo de la detección de placas ateroscleróticas carotídeas, en combinación con los niveles de hemoglobina glicosilada A1c y proteína C reactiva, para la progresión de la enfermedad en pacientes jóvenes con accidente cerebrovascular isquémico agudo.

• Shuting Jiang Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China. https://orcid.org/0009-0004-7236-8127
• Hongquan Liu Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China. https://orcid.org/0009-0003-5246-3939
• Chen Zhong Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Key Laboratory of Liver Transplantation, Nanjing, Jiangsu Province, China. https://orcid.org/0009-0009-6729-6823
• Jie Yang Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China. https://orcid.org/0009-0004-8218-9376
• Yue Qin Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China. https://orcid.org/0009-0006-7083-8679
• Yechen Lu Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China. https://orcid.org/0009-0005-6100-435X
• Mingming Fang Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China. https://orcid.org/0009-0007-8211-0789

DOI: https://doi.org/10.54817/IC.v67n2a04

Palabras clave: Accidente Cerebrovascular Isquémico, Placa Aterosclerótica, Arterias Carótidas, Proteína C-Reactiva, Hemoglobina HA1c

Resumen

Este estudio evaluó la significancia predictiva de combinar placas ateroscleróticas carotídeas con niveles de hemoglobina glicosilada A1c (HbA1c) y proteína C reactiva (PCR) para la progresión de la enfermedad en pacientes jóvenes con accidente cerebrovascular isquémico agudo (AIS). Se reclutó de manera uniforme un total de 130 sujetos, que comprendían pacientes jóvenes con AIS ingresados entre enero de 2015 y marzo de 2025 (grupo de casos) e individuos sanos sometidos a exámenes físicos durante el mismo pe- ríodo (grupo de control). Se realizaron comparaciones en la tasa de incidencia de placas ateroscleróticas carotídeas y los niveles séricos de HbA1c y PCR. El grupo de casos se categorizó en grupos leve-moderado y grave según la pun- tuación de la Escala de Accidente Cerebrovascular del Instituto Nacional de Salud (NIHSS). Se observaron diferencias significativas entre los grupos grave y leve-moderado en las puntuaciones NIHSS, la incidencia de placa ateroscle- rótica carotídea y los niveles séricos de HbA1c y PCR (p<0,05). El aumento de los niveles séricos de HbA1c, los niveles elevados de PCR y la presencia de placas ateroscleróticas carotídeas funcionaron como factores de riesgo para la progresión del AIS en pacientes jóvenes (odds ratio > 1, p<0,05). Los nive- les séricos de HbA1c y PCR, junto con la presencia de placas ateroscleróticas carotídeas, mostraron una correlación positiva con las puntuaciones NIHSS (r>0, p<0,05). Las áreas bajo las curvas ROC de los niveles séricos de HbA1c y PCR, las placas ateroscleróticas carotídeas y su combinación para evaluar la progresión del AIS en pacientes jóvenes fueron 0,810, 0,823, 0,781 y 0,905, respectivamente. Los niveles elevados de HbA1c, PCR y presencia de placas carotídeas se asocian con la gravedad del AIS en pacientes jóvenes. La detección combinada mejora la precisión predictiva, lo que sugiere utilidad clínica para la estratificación del riesgo.

Citas

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