Protective properties of HDL cholesterol and atherosclerotic plaque calcifications in advanced atherosclerosis in ischaemic stroke patients

Dariusz Kotlęga, Jędrzej Stolarczyk, Aleksandra Karpowicz, Joanna Jarowicz, Anna Bajer‑Czajkowska, Przemysław Nowacki


Introduction: Atherosclerotic changes in carotid arteries play an important role in the pathogenesis of ischaemic stroke. To a high extent there is evident asymmetry within the development of these changes, affecting just one artery.

The aim of the study was to determine the impact of the cardiovascular risk factors on the presence of haemodynamically significant atherosclerotic changes or occlusion only in one compared to both of the carotid arteries in patients with ischaemic stroke.

Material and methods: Patients diagnosed with ischaemic stroke were retrospectively assessed towards stenosis of ≥70% or occlusion in at least one of the internal or common carotid arteries. There were 104 patients enrolled in the study. Group I consisted of individuals with haemodynamically significant (≥70%) stenosis or occlusion in one carotid artery (n = 48). Group II consisted of patients with bilateral significant (≥70%) stenosis or occlusion in carotid arteries (n = 56).

Results: There were no changes found in the presence of non­‍-modifiable stroke risk factors between the groups. In group I higher HDL level (45.7 vs 38.9 mg/dL, p = 0.038) and significantly more frequent calcifications in the atherosclerotic plaques of carotid arteries were found (p = 0.03). There were no differences in other tested factors between groups.

Conclusions: The protective properties of HDL cholesterol and the slow formation of more stable, calcified plaques play an important role only in the development of unilateral advanced atherosclerosis in carotid arteries. The role of HDL cholesterol in stroke pathomechanism needs further studies.


cerebral stroke; atherosclerosis, risk factors; high­‍-density lipoproteins; carotid arteries

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