Inflammation stroke risk

Inflammation in the plaque wall has been postulated to influence thrombus formation in myocardial infarction (Ml) as well as stroke. Recent studies have focused on the possibility that infection in the plaque contributes to thrombus formation and subsequent stroke or Ml. Chlamydia pneumoniae particles have been recently discovered in carotid and coronary plaques [15]. Although several studies have shown an association between elevated serum antibody titers for Chlamydia pneumoniae and cerebrovascular and cardiovascular events, there remains no clear evidence of stroke risk reduction associated with antibiotic therapy [6, 16]. Another condition that can produce progressive carotid narrowing not due to atherosclerosis is intimal hyperplasia, which can occur after radiation treatment to the neck or prior carotid endarterectomy. 

Association between moderately elevated levels of Hey and stroke patients with chronic inflammation, as well as those with chronic or acute infection, are at elevated stroke risk. 

The FDA approved this selective cyclooxigenase (COX)-2 inhibitor (Vioxx) for the treatment of pain and inflammation in 1999. This NSAID demonstrated to have a lower risk of side effects such as gastrointestinal ulcers and bleeding than nonse-lective COX inhibitors, for example, ibuprofen. In 2004, a long-term study of Vioxx in patients at increased risk of colon polyps was halted because of an increased cardiovascular risk (heart attack, stroke) in the rofecoxib group. Subsequently, Merck withdrew the drug from the world market at the end of September 2004 [46]. 

Findsberg PJ, Grau AJ. (2003) Inflammation and infections as risk factors for ischemic stroke. Stroke 4 2518-2532. 

The statins may lower the risk of CHD by decreasing inflammation, an important component of atherogene-sis. Lovastatin decreased elevated plasma levels of C-reactive protein, a marker for cellular inflammation, and acute coronary events in patients with relatively low plasma cholesterol levels. Recent studies also suggest that use of statins may decrease the risk of stroke, dementia, and Alzheimer s disease and may improve bone... 

Elevated body temperature is one of the most toxic effects of ecstasy, and this risk is augmented by its use at dance parties and raves. The lack of air circulation in a crowded environment creates an elevated room temperature, which, together with increases in body temperature can cause brain toxicity similar to heat stroke. High body temperature can also lead to severe liver inflammation or damage, abnormal blood clotting, and death. 

Several prospective studies have shown that markers of inflammation, such as sensitive C-reactive protein and serum amyloid A (S-AA), are predictors of increased risk for myocardial infarction, stroke, or peripheral vascular disease (53-56). 

Aspirin acts by interfering with the synthesis of prostaglandins, which are connected to the causes of inflammation and fever. In particular it is an inhibitor of the cyclo-oxygenase (Cox-2) enzyme. Studies of the use of aspirin as an anticlotting agent suggest that half an aspirin tablet per day may reduce the risk of heart attack and stroke in some people.3... 

There is also good evidence that inflammation has a causal role in carotid plaque instability (van der Wal et al. 1994 Redgrave et al. 2006). Visualization of plaque macrophages by MRI after their uptake of ultra-small particles of iron oxide is now possible (Trivedi et al. 2004 Tang et al. 2006). However, large prospective studies are required to determine whether these imaging characteristics predict the risk of stroke. 

Recent investigations have also revealed that alcohol reduces inflammation in the arteries. Doctors have noted that people with heart disease have higher levels of inflammation and, conversely, individuals with little inflammation are at lessened risk of developing the disease and/or suffering a heart attack or a stroke. 

The authors reported that deaths related to praziquantel in neurocysticercosis are rare. However, this case had characteristics suggestive of a high risk of post-treatment complications. Death was attributed to a sudden increase in intracranial pressure, with multiple foci of edema, meningeal inflammation, and stroke, and occurred despite the concomitant use of glucocorticoids. 

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