J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://www.jocmr.org

Original Article

Volume 12, Number 9, September 2020, pages 598-603

Association Between Serum Apolipoprotein A1 Levels, Ischemic Stroke Subtypes and Plaque Properties of the Carotid Artery

**Table 1.** Clinical Characteristics of the Participants in the ATBI, CE, LI, and Control Groups
	ATBI (n = 52)	CE (n = 15)	LI (n = 25)	CONT (n = 21)
^aP < 0.05, vs. CONT, ^bP < 0.05, vs. CE, ^cP < 0.05, vs. LI. ATBI: atherothrombotic infarction; CE: cardioembolic infarction; LI: lacuna infraction; CONT: control; BMI: body mass index; SBP: systolic blood pressure; DBP: diastolic blood pressure.
Age, years	69.7 ± 10.4	66.0 ± 12.3	71.9 ± 9.8	67.5 ± 8.0
Female, %	55.8	60.0	68.0	38.1
BMI, kg/m²	23.5 ± 3.3	22.5 ± 3.6	22.1 ± 2.6	23.4 ± 3.5
SBP, mm Hg	131.7 ± 17.9	127.5 ± 17.6	134.7 ± 21.4	132.7 ± 13.5
DBP, mm Hg	73.3 ± 11.6	75.3 ± 8.3	72.6 ± 12.2	74.4 ± 11.9
Current smoker, %	33.3	20.0	28.0	14.3
Current alcohol drinker, %	37.3	53.3	36.0	19.0
Hypertension, %	94.2^b	60.0	80.0	81.0
Diabetes, %	34.6	6.7	28.0	20.0
Hyperlipidemia, %	78.8^c	60.0^c	96.0^a	61.9
Atrial fibrillation, %	7.7^b	100.0^{a, c}	4.0	4.8
Statin, %	84.6^c	53.8	50.0	66.7

Table 1. Clinical Characteristics of the Participants in the ATBI, CE, LI, and Control Groups

ATBI (n = 52)

CE (n = 15)

LI (n = 25)

CONT (n = 21)

^aP < 0.05, vs. CONT, ^bP < 0.05, vs. CE, ^cP < 0.05, vs. LI. ATBI: atherothrombotic infarction; CE: cardioembolic infarction; LI: lacuna infraction; CONT: control; BMI: body mass index; SBP: systolic blood pressure; DBP: diastolic blood pressure.

Age, years

69.7 ± 10.4

66.0 ± 12.3

71.9 ± 9.8

67.5 ± 8.0

Female, %

55.8

60.0

68.0

38.1

BMI, kg/m²

23.5 ± 3.3

22.5 ± 3.6

22.1 ± 2.6

23.4 ± 3.5

SBP, mm Hg

131.7 ± 17.9

127.5 ± 17.6

134.7 ± 21.4

132.7 ± 13.5

DBP, mm Hg

73.3 ± 11.6

75.3 ± 8.3

72.6 ± 12.2

74.4 ± 11.9

Current smoker, %

33.3

20.0

28.0

14.3

Current alcohol drinker, %

37.3

53.3

36.0

19.0

Hypertension, %

94.2^b

60.0

80.0

81.0

Diabetes, %

34.6

6.7

28.0

20.0

Hyperlipidemia, %

78.8^c

60.0^c

96.0^a

61.9

Atrial fibrillation, %

7.7^b

100.0^{a, c}

4.0

4.8

Statin, %

84.6^c

53.8

50.0

66.7

**Table 2.** Serum Lipids and Apolipoproteins of the Participants in the ATBI, CE, LI, and Control Groups
	ATBI (n = 52)	CE (n = 15)	LI (n = 25)	CONT (n = 21)
^aP < 0.05, vs. CONT. ATBI: atherothrombotic infarction; CE: cardioembolic infarction; LI: lacuna infraction; CONT: control; TC: total cholesterol; LDL-C: low-density lipoprotein cholesterol; MDA-LDL: malondialdehyde-modified low-density lipoprotein; HDL-C: high-density lipoprotein cholesterol; TG: triglyceride; RLP-C: remnant lipoprotein cholesterol; Lp(a): lipoprotein(a); ApoA1: apolipoprotein A1; ApoA2: apolipoprotein A2; ApoB: apolipoprotein B; ApoC1: apolipoprotein C1; ApoC2: apolipoprotein C2; ApoE: apolipoprotein E; HbA1c: hemoglobin A1c.
Serum lipids
TC, mg/dL	178.4 ± 43.0	195.3 ± 35.8	195.6 ± 55.4	205.6 ± 29.7
LDL-C, mg/dL	106.8 ± 29.7	113.1 ± 27.1	121.0 ± 39.6	118.6 ± 32.2
MDA-LDL, U/L	103.8 ± 44.7	130.7 ± 48.9	100.8 ± 45.1	92.4 ± 18.5
HDL-C, mg/dL	54.6 ± 12.5	57.5 ± 19.4	66.2 ± 17.1	67.0 ± 23.7
TG, mg/dL	147.9 ± 84.2	161.7 ± 107.9	128.5 ± 82.2	142.5 ± 62.9
RLP-C, mg/dL	6.7 ± 7.0	10.0 ± 7.5	7.1 ± 5.1	6.8 ± 3.2
Lp(a), mg/dL	18.0 ± 21.7	21.3 ± 33.5	29.1 ± 44.2	14.8 ± 12.0
Apolipoproteins
ApoA1, mg/dL	128.6 ± 19.6^a	131.9 ± 25.3	139.2 ± 17.1	149.3 ± 21.5
ApoA2, mg/dL	27.9 ± 4.9	30.2 ± 5.5	27.4 ± 4.3	30.1 ± 4.7
ApoB, mg/dL	79.1 ± 17.3	89.2 ± 16.6	80.6 ± 29.1	76.5 ± 9.2
ApoC2, mg/dL	4.5 ± 1.7	5.9 ± 2.3	4.7 ± 2.4	4.9 ± 1.7
ApoC3, mg/dL	9.9 ± 4.3	11.2 ± 3.5	9.9 ± 3.4	10.7 ± 3.0
ApoE, mg/dL	3.1 ± 1.2	3.7 ± 1.2	3.4 ± 1.3	3.4 ± 0.8
HbA1c, %	6.6 ± 1.5	6.0 ± 1.8	6.4 ± 1.3	6.1 ± 0.7

Table 2. Serum Lipids and Apolipoproteins of the Participants in the ATBI, CE, LI, and Control Groups

ATBI (n = 52)

CE (n = 15)

LI (n = 25)

CONT (n = 21)

^aP < 0.05, vs. CONT. ATBI: atherothrombotic infarction; CE: cardioembolic infarction; LI: lacuna infraction; CONT: control; TC: total cholesterol; LDL-C: low-density lipoprotein cholesterol; MDA-LDL: malondialdehyde-modified low-density lipoprotein; HDL-C: high-density lipoprotein cholesterol; TG: triglyceride; RLP-C: remnant lipoprotein cholesterol; Lp(a): lipoprotein(a); ApoA1: apolipoprotein A1; ApoA2: apolipoprotein A2; ApoB: apolipoprotein B; ApoC1: apolipoprotein C1; ApoC2: apolipoprotein C2; ApoE: apolipoprotein E; HbA1c: hemoglobin A1c.

Serum lipids

TC, mg/dL

178.4 ± 43.0

195.3 ± 35.8

195.6 ± 55.4

205.6 ± 29.7

LDL-C, mg/dL

106.8 ± 29.7

113.1 ± 27.1

121.0 ± 39.6

118.6 ± 32.2

MDA-LDL, U/L

103.8 ± 44.7

130.7 ± 48.9

100.8 ± 45.1

92.4 ± 18.5

HDL-C, mg/dL

54.6 ± 12.5

57.5 ± 19.4

66.2 ± 17.1

67.0 ± 23.7

TG, mg/dL

147.9 ± 84.2

161.7 ± 107.9

128.5 ± 82.2

142.5 ± 62.9

RLP-C, mg/dL

6.7 ± 7.0

10.0 ± 7.5

7.1 ± 5.1

6.8 ± 3.2

Lp(a), mg/dL

18.0 ± 21.7

21.3 ± 33.5

29.1 ± 44.2

14.8 ± 12.0

Apolipoproteins

ApoA1, mg/dL

128.6 ± 19.6^a

131.9 ± 25.3

139.2 ± 17.1

149.3 ± 21.5

ApoA2, mg/dL

27.9 ± 4.9

30.2 ± 5.5

27.4 ± 4.3

30.1 ± 4.7

ApoB, mg/dL

79.1 ± 17.3

89.2 ± 16.6

80.6 ± 29.1

76.5 ± 9.2

ApoC2, mg/dL

4.5 ± 1.7

5.9 ± 2.3

4.7 ± 2.4

4.9 ± 1.7

ApoC3, mg/dL

9.9 ± 4.3

11.2 ± 3.5

9.9 ± 3.4

10.7 ± 3.0

ApoE, mg/dL

3.1 ± 1.2

3.7 ± 1.2

3.4 ± 1.3

3.4 ± 0.8

HbA1c, %

6.6 ± 1.5

6.0 ± 1.8

6.4 ± 1.3

6.1 ± 0.7

**Table 3.** Ultrasound Evaluation of the ATBI, CE, LI, and Control Groups
Variables	ATBI	CE	LI	CONT
^aP < 0.05, vs. CONT, ^bP < 0.05, vs. CE, ^cP < 0.05, vs. LI. ATBI: atherothrombotic infraction; CE: cardioembolic infarction; LI: lacuna infraction; CONT: control; CCA: common carotid artery; BIF: carotid bifurcation; ICA: internal carotid artery; EDV: end-diastolic velocity; PSV: peak systolic velocity; mean V: mean velocity; PI: pulsatility index; IMT: intra-media thickness.
CCA, number of plaques	1.5 ± 1.5^{a, b, c}	0.0 ± 0.0	0.3 ± 1.0	0.2 ± 0.7
CCA plaque thickness, mm	2.2 ± 1.1	-	2.9	1.4, 2.0
BIF, number of plaques	2.1 ± 1.3^{a, b, c}	0.3 ± 1.0	0.7 ± 1.3	0.3 ± 1.0
BIF plaque thickness, mm	2.2 ± 1.1	2.9	2.2 ± 0.9	1.9, 2.2
ICA, number of plaques	1.7 ± 1.3^{a, b, c}	0.1± 0.5	0.5 ± 0.9	0.1 ± 0.5
ICA plaque thickness, mm	2.5 ± 1.1	2	2.2 ± 0.9	2.3
Significant stenosis,%	13.7^{a, b, c}	0	0	0
PSV, cm/s	62.2 ± 19.4	55.6 ± 10.1	69.8 ± 18.0	65.3 ± 19.6
EDV, cm/s	14.2 ± 5.3	13.2 ± 2.9	13.8 ± 3.5	16.5 ± 5.9
Mean V, cm/s	25.6 ± 7.2	23.9 ± 3.6	28.0 ± 6.3	30.4 ± 8.5
PI	2.4 ± 2.0	1.8 ± 0.4	2.0 ± 0.4	1.7 ± 0.7
Mean IMT of CCA, mm	0.9 ± 0.3	0.8 ± 0.1	0.8 ± 0.2	0.8 ± 0.2
Plaque category
Non-plaque, %	5.9^{a, b, c}	86.7	62.5	89.5
Soft, %	17.6^{a, b, c}	0	0	0
Intermediate, %	39.2^{a, b, c}	6.7	16.7	10.5
Hard, %	37.3^{a, b, c}	6.7	20.8	0

Table 3. Ultrasound Evaluation of the ATBI, CE, LI, and Control Groups

Variables

ATBI

CONT

^aP < 0.05, vs. CONT, ^bP < 0.05, vs. CE, ^cP < 0.05, vs. LI. ATBI: atherothrombotic infraction; CE: cardioembolic infarction; LI: lacuna infraction; CONT: control; CCA: common carotid artery; BIF: carotid bifurcation; ICA: internal carotid artery; EDV: end-diastolic velocity; PSV: peak systolic velocity; mean V: mean velocity; PI: pulsatility index; IMT: intra-media thickness.

CCA, number of plaques

1.5 ± 1.5^{a, b, c}

0.0 ± 0.0

0.3 ± 1.0

0.2 ± 0.7

CCA plaque thickness, mm

2.2 ± 1.1

2.9

1.4, 2.0

BIF, number of plaques

2.1 ± 1.3^{a, b, c}

0.3 ± 1.0

0.7 ± 1.3

0.3 ± 1.0

BIF plaque thickness, mm

2.2 ± 1.1

2.9

2.2 ± 0.9

1.9, 2.2

ICA, number of plaques

1.7 ± 1.3^{a, b, c}

0.1± 0.5

0.5 ± 0.9

0.1 ± 0.5

ICA plaque thickness, mm

2.5 ± 1.1

2.2 ± 0.9

2.3

Significant stenosis,%

13.7^{a, b, c}

PSV, cm/s

62.2 ± 19.4

55.6 ± 10.1

69.8 ± 18.0

65.3 ± 19.6

EDV, cm/s

14.2 ± 5.3

13.2 ± 2.9

13.8 ± 3.5

16.5 ± 5.9

Mean V, cm/s

25.6 ± 7.2

23.9 ± 3.6

28.0 ± 6.3

30.4 ± 8.5

2.4 ± 2.0

1.8 ± 0.4

2.0 ± 0.4

1.7 ± 0.7

Mean IMT of CCA, mm

0.9 ± 0.3

0.8 ± 0.1

0.8 ± 0.2

Plaque category

Non-plaque, %

5.9^{a, b, c}

86.7

62.5

89.5

Soft, %

17.6^{a, b, c}

Intermediate, %

39.2^{a, b, c}

6.7

16.7

10.5

Hard, %

37.3^{a, b, c}

6.7

20.8

**Table 4.** Serum Lipids and Apolipoproteins Between the Heterogeneous and Homogeneous Type in the ATBI Group
Variables	Heterogeneous type (n = 21 )	Homogenous type (n = 27)
^aP < 0.05, vs. homogenous type. ATBI: atherothrombotic infraction; TC: total cholesterol; LDL-C: low-density lipoprotein cholesterol; MDA-LDL: malondialdehyde-modified low-density lipoprotein; HDL-C: high-density lipoprotein cholesterol; TG: triglyceride; RLP-C: remnant lipoprotein cholesterol; Lp(a): lipoprotein(a); ApoA1: apolipoprotein A1; ApoA2: apolipoprotein A2; ApoB: apolipoprotein B; ApoC1: apolipoprotein C1; ApoC2: apolipoprotein C2; ApoE: apolipoprotein E; HbA1c: hemoglobin A1c.
Serum lipids
TC, mg/dL	170.0 ± 23.2^a	188.4 ± 39.3
LDL-C, mg/dL	98.0 ± 23.2	113.6 ± 31.6
MDA-LDL, U/L	87.0 ± 33.3^a	116.9 ± 50.3
HDL-C, mg/dL	53.6 ± 13.7	54.3 ± 10.9
TG, mg/dL	123.2 ± 43.4	153.7 ± 92.0
RLP-C, mg/dL	7.0 ± 8.9	5.8 ± 4.0
Lp (a), mg/dL	28.3 ± 28.5^a	10.6 ± 9.4
Apolipoproteins
ApoA1, mg/dL	121.0 ± 19.6^a	133.8 ± 19.2
ApoA2, mg/dL	26.0 ± 4.2^a	29.3 ± 5.4
ApoB, mg/dL	74.7 ± 15.9	82.4 ± 18.4
ApoC2, mg/dL	4.2 ± 1.8	4.7 ± 1.5
ApoC3, mg/dL	8.6 ± 3.4	10.4 ± 4.4
ApoE, mg/dL	2.8 ± 0.9	3.2 ± 1.3
HbA1c, %	6.6 ± 1.3	6.5 ± 1.6

Table 4. Serum Lipids and Apolipoproteins Between the Heterogeneous and Homogeneous Type in the ATBI Group

Variables

Heterogeneous type (n = 21 )

Homogenous type (n = 27)

^aP < 0.05, vs. homogenous type. ATBI: atherothrombotic infraction; TC: total cholesterol; LDL-C: low-density lipoprotein cholesterol; MDA-LDL: malondialdehyde-modified low-density lipoprotein; HDL-C: high-density lipoprotein cholesterol; TG: triglyceride; RLP-C: remnant lipoprotein cholesterol; Lp(a): lipoprotein(a); ApoA1: apolipoprotein A1; ApoA2: apolipoprotein A2; ApoB: apolipoprotein B; ApoC1: apolipoprotein C1; ApoC2: apolipoprotein C2; ApoE: apolipoprotein E; HbA1c: hemoglobin A1c.

Serum lipids

TC, mg/dL

170.0 ± 23.2^a

188.4 ± 39.3

LDL-C, mg/dL

98.0 ± 23.2

113.6 ± 31.6

MDA-LDL, U/L

87.0 ± 33.3^a

116.9 ± 50.3

HDL-C, mg/dL

53.6 ± 13.7

54.3 ± 10.9

TG, mg/dL

123.2 ± 43.4

153.7 ± 92.0

RLP-C, mg/dL

7.0 ± 8.9

5.8 ± 4.0

Lp (a), mg/dL

28.3 ± 28.5^a

10.6 ± 9.4

Apolipoproteins

ApoA1, mg/dL

121.0 ± 19.6^a

133.8 ± 19.2

ApoA2, mg/dL

26.0 ± 4.2^a

29.3 ± 5.4

ApoB, mg/dL

74.7 ± 15.9

82.4 ± 18.4

ApoC2, mg/dL

4.2 ± 1.8

4.7 ± 1.5

ApoC3, mg/dL

8.6 ± 3.4

10.4 ± 4.4

ApoE, mg/dL

2.8 ± 0.9

3.2 ± 1.3

HbA1c, %

6.6 ± 1.3

6.5 ± 1.6