Abstract Details

Title Serum Alpha-1 Antitrypsin and atherosclerosis burden in patients with acute ischemic stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P14 - Poster Session 14 (8:00 AM-9:00 AM)

Poster/Presentation
Number 4-020

Objective

We sought to explore potential relationships between ischemic stroke mechanisms, cerebrovascular atherosclerosis burden and serum AAT levels.

Background Alpha-1 antitrypsin (AAT) is a potent anti-protease enzyme which may play a role in arterial wall stability. A variant of its encoding gene has been recently linked to ischemic stroke due to large artery atherosclerosis (LAA).

Design/Methods We performed a prospective observational cohort study of consecutive patients with acute ischemic stroke who were admitted to an academic comprehensive stroke center over a three-month period. We measured major cervico-cranial arterial calcification as a surrogate for atherosclerosis burden using the modified Woodcock (MW) scoring system, then used linear regression to determine the association between patients’ serum AAT levels and calcification scores. We also compared serum AAT levels between patients with LAA and those non-LAA stroke mechanisms using Mann-Whitney testing.

Results There were 18 patients in our study (mean age 63 years [SD 12.5], 56% male (n=10), 44% (n=8) with stroke due to LAA). Median AAT level was 140mg/dl (IQR 41.7) for patients with LAA-related stroke and 148.5mg/dl (IQR 37.7) for patients with other stroke mechanisms (p=0.26). Lower serum AAT levels were associated with higher MW scores (5.4 points per 10 mg/dl change in serum AAT [95% CI 0.32-10].

Conclusions

Measurement of AAT levels in patients with acute stroke is feasible, and there may be associations between AAT and stroke mechanism that warrant further study in larger samples.

Authors/Disclosures
Ali Mahta, MD (Brown University) PRESENTER	Dr. Mahta has received research support from Brown University Health.
Shadi Yaghi, MD (Hackensack Meridian Health)	Dr. Yaghi has nothing to disclose.
Michael Reznik, MD (Rhode Island Hospital)	Dr. Reznik has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Morrison Mahoney. The institution of Dr. Reznik has received research support from NIDUS.
Bradford B. Thompson, MD (St. Elizabeth’s Medical Center)	Dr. Thompson has nothing to disclose.
Linda C. Wendell, MD, F�鶹��ýӳ�� (Mount Auburn Hospital)	Dr. Wendell has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various. An immediate family member of Dr. Wendell has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various. Dr. Wendell has stock in Apple. An immediate family member of Dr. Wendell has stock in Apple.
Shyam S. Rao, MD (Rhode Island Hospital, Brown University)	No disclosure on file
	No disclosure on file
Katarina B. Dakay, DO	No disclosure on file
Shawna M. Cutting, MD, F�鶹��ýӳ��	The institution of Dr. Cutting has received research support from Genentech.
Brian Mac Grory, MB BCh BAO (Duke University School of Medicine)	An immediate family member of Dr. Mac Grory has received personal compensation for serving as an employee of Sanofi. Dr. Mac Grory has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Stroke. The institution of Dr. Mac Grory has received research support from National Institutes of Health. The institution of Dr. Mac Grory has received research support from American Heart Association.
Tina M. Burton, MD	Dr. Burton has nothing to disclose.
Ali Saad, MD, F�鶹��ýӳ��	Dr. Saad has nothing to disclose.
Daniel Sacchetti, DO, F�鶹��ýӳ��	Dr. Sacchetti has nothing to disclose.
	No disclosure on file
Scott Moody	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Hooman Kamel, MD (Weill Cornell Medical College)	Dr. Kamel has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Kamel has received personal compensation in the range of $50,000-$99,999 for serving as a Endpoint adjudication committee with Boehringer-Ingelheim.
Karen L. Furie, MD (RIH/Alpert Medical School of Brown Univ)	The institution of Dr. Furie has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen/BMS. Dr. Furie has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for BMJ/JNNP. The institution of Dr. Furie has received research support from NINDS.

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