Relationship Between Arylesterase Activity and Pulse Pressure Index in Patients with an Acute Ischemic Stroke

Abstract

Background: Stroke is a multifactorial disease. Arylesterase (ARE) activities have been considered as an anti-atherosclerosis factor. Increased pulse pressure (PP) may lead to a high risk of coronary artery disease and neurovascular morbidity and mortality. Nevertheless, there are limitations for PP as an evaluation index. Objectives: In order to overcome the defects of PP, there is a novel parameter, “pulse pressure/systolic pressure” named “pulse pressure index (PPI)” for evaluation of cardiovascular effect. We researched the relationship between ARE activities and pulse pressure index (PPI) in acute ischemic stroke patients. Methods: We evaluated and compared the ARE activity and PPI in 87 ischemic stroke patients and 48 control patients. ARE activity was measured with the ultraviolet (UV) spectrophotometric method by using “Rel Assay Diagnostic” kits . Pulse pressure was measured by subtraction of diastolic blood pressure from systolic blood pressure. PPI was calculated as “ pulse pressure / systolic pressure”. Results: Hypertension, age, diabetes mellitus, dyslipidemia importantly higher in ischemic stroke patients than the control group (p<0.05). PPI was significantly higher in ischemic stroke patients than the control group (0.486±0.075 and 0.417±0.051, p<0.05). ARE activity was significantly lower in ischemic stroke patients than in the control group (511.59 ± 68.51 and 584.16 ± 81.74 p=0.019). Conclusion: This study demonstrated that ARE activity is lower and PPI is higher in acute ischemic stroke patients than control subjects. Our results suggested that, ARE activity and PPI are important risk factors in acute ischemic stroke patients.

Keywords

• Arylesterase
• pulse pressure
• index
• stroke

References

1. Assmann, G., Cullen, P., Evers, T., Petzinna, D., Schulte, H., 2005. Importance of arterial pulse pressure as a predictor of coronary heart disease risk in PROCAM. Eur. Heart. J. 26(20), 2120-2126.
2. Aydin, O.P., Yilmaz, T., Ozturk, U., 2019. Effects of Bemiparin Sodium Versus Dabigatran Etexilate After Anastomosis in Rat Carotid Arteries on the Development of Neointima and Thrombolytic Efficacy. World. Neurosurg. 126, e731-e735.
3. Cai, A., Mo, Y., Zhang, Y., Li, J., Chen, J., Zhou, Y., Chen, R., Wei, R., Huang, Y., Tang, S., Feng, Y., 2015. Relationship of pulse pressure index and carotid intima-media thickness in hypertensive adults. Clin. Exp. Hypertens. 37(4), 267-270.
4. Demirdogen, C., Türkanoğlu, B.A., Bek, S., Sanisoğlu, Y., Demirkaya, S., Vural, O., Arinc, E., Adali, O., 2008. Paraoxonase/arylesterase ratio, PON1 192Q/R polymorphism and PON1 status are associated with increased risk of ischemic stroke. Clin. Biochem. 41(1-2), 1-9.
5. Castillo, J., Leira, R., García, M.M., Serena, J., Blanco, M., Dávalos, A., 2004. Blood pressure decrease during the acute phase of ischemic stroke is associated with brain injury and poor stroke outcome. Stroke. 35(2), 520-526.
6. Chang, J. J., Khorchid, Y., Dillard, K., Kerro, A., Burgess, L.G., Cherkassky, G., Goyal, N., Chapple, K., Alexandrov, A.W., Buechner, D., Alexandrov, A.V., Tsivgoulis, G., 2017. Elevated Pulse Pressure Levels Are Associated With Increased In-Hospital Mortality in Acute Spontaneous Intracerebral Hemorrhage. Am. J. Hypertens. 30(7), 719-727.
7. Chawhan, S. S., Mogarekar, M.R., Wagh, R.V., Das, R.R., Pramanik, S.S., Sonune S.M., Chawhan, S.M., 2015. Relation of Paraoxonase1, Arylesterase and Lipid Profile in Ischemic Stroke Patients. J. Clin. Diagn. Res. 9(11), Bc01-03.
8. Chobanian, A. V., Bakris, G.L., Black, H.R., Cushman, W.C., Green, L.A., Izzo, J.L., Jones, D.W., Materson, B.J., Oparil, S., Wright, J.T., Roccella, E.J., 2003. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 42(6), 1206-1252.

9. Feigin, V. L., Forouzanfar, M.H., Krishnamurthi, R., Mensah, G.A., Connor, M., Bennett, D.A., Moran, A.E., Sacco, R.L., Anderson, L., Truelsen, T., O'Donnell, M., Venketasubramanian, N., Barker-Collo, S., Lawes, C.M., Wang, W., Shinohara, Y., Witt, E., Ezzati, M., Naghavi, M., Murray, C., 2014. Global and regional burden of stroke during 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet. 383(9913), 245-254.
10. Glasser, S. P., Halberg, D.L., Sands, C.D., Mosher, A., Muntner, P.M., Howard, G., 2015. Is Pulse Pressure an Independent Risk Factor for Incident Stroke, REasons for Geographic And Racial Differences in Stroke. Am. J. Hypertens. 28(8), 987-994.
11. Hendrix, P., Sofoluke, N., Adams, M.D.,Kunaprayoon, S., Zand, R., Kolinovsky, A.N., Person, T.N., Gupta, M, Goren, O, Schirmer, C.M., Rost, N.S., Faber, J.E., Griessenauer, C.J., 2019. Risk Factors for Acute Ischemic Stroke Caused by Anterior Large Vessel Occlusion. Stroke. 50(5), 1074-1080.
12. Kim, N. S., Kang, K., Cha, M.H., Kang, B.J., Moon, J., Kang, B.K., Yu, B.C., Kim, Y.S., Choi, S.M., Bang, O.S., 2007. Decreased paraoxonase-1 activity is a risk factor for ischemic stroke in Koreans. Biochem. Biophys. Res. Commun. 364(1), 157-162.
13. Lee, H.W., Kim, K.J., Han, B.J., Kim, M.K., Cho, J.T., Shin, K.H., Yeo, D.I., Cha, M.J., Kim, J.K., Nah, D.H., Kim, D.E., Ryu, W.S., Park, J.M., Kang, K., Lee, S.J., Oh, M.S., Yu, K.S., Lee, B.C., Hong, K.S., Cho, Y.J., Choi, J.C., Sohn, S.I., Hong, J.H., Park, T.H., Park, S.S., Kwon, J.H., Kim, W.J.,Lee, J., Lee, J.S., Lee, J., Gorelick,P.B., Bae,H.J., 2018. Predictive Value of Pulse Pressure in Acute Ischemic Stroke for Future Major Vascular Events. Stroke. 49(1), 46-53.
14. Lindsberg, P. J., Roine, R.O., 2004. Hyperglycemia in acute stroke. Stroke. 35(2), 363-364. Lyden, P., 2017. Using the National Institutes of Health Stroke Scale: A Cautionary Tale. Stroke. 48(2), 513-519.
15. Lynch, A. I., Arnett, D.K., Pankow, J.S., Miller, M.B., North, K.E., Eckfeldt, J.H., Hunt, S.C., Rao D.C., Djoussé, L, 2007. Sex-specific effects of ACE I/D and AGT-M235T on pulse pressure: the HyperGEN Study. Hum. Genet. 122(1), 33-40.
16. Mackness, M. I., Arrol, S., Durrington, P.N., 1991. Paraoxonase prevents accumulation of lipoperoxides in low-density lipoprotein. FEBS. Lett. 286(1-2), 152-154.
17. Michalak, S., Kazmierski, R., Hellmann, A., Wysocka, E., Kocialkowska-Adamczewska, D., Wencel-Warot, A., Nowinski, W.L. ,2011. Serum paraoxonase/arylesterase activity affects outcome in ischemic stroke patients. Cerebrovasc. Dis. 32(2), 124-132.
18. Miura, K., Nakagawa, H., Ohashi, Y., Harada, A., Taguri, M., Kushiro, T., Takahashi, A., Nishinaga, M., Soejima, H., Ueshima, H., 2009. Four blood pressure indexes and the risk of stroke and myocardial infarction in Japanese men and women: a meta-analysis of 16 cohort studies. Circulation. 119(14), 1892-1898.
19. Miyajima, K., Minatoguchi, S, Ito, Y., Hukunishi, M., Matsuno, Y., Kakami, M., Kawasaki, M., Nishigaki, K., Takemura, G., Fujiwara, H., 2007. Reduction of QTc dispersion by the angiotensin II receptor blocker valsartan may be related to its anti-oxidative stress effect in patients with essential hypertension. Hypertens. Res. 30(4), 307-313.
20. Morfis, L., Schwartz, R.S., Poulos, R., Howes, L.G., 1997. Blood pressure changes in acute cerebral infarction and hemorrhage. Stroke. 28(7), 1401-1405.
21. Mostofsky, E., Wellenius, G.A., Noheria, A., Levitan, E.B., Burger, M.R., Schlaug, G., Mittleman, M.A., 2009. Renal function predicts survival in patients with acute ischemic stroke. Cerebrovasc. Dis. 28(1), 88-94.
22. Öztürk, Ü., Ozturk, O., 2019. Assessment of Myocardial Function by Myocardial Performance Index in Patients with Acute Ischemic Stroke. Dicle Med. J. 46, 715-723.
23. Ripoll, J. G., Blackshear, J.L., Díaz-Gómez, J.L., 2018. Acute Cardiac Complications in Critical Brain Disease. Neurosurg. Clin. N. Am. 29(2), 281-297.
24. Rozenberg, O., Shih, D.M., Aviram, M., 2003. Human serum paraoxonase 1 decreases macrophage cholesterol biosynthesis: possible role for its phospholipase-A2-like activity and lysophosphatidylcholine formation. Arterioscler. Thromb. Vasc. Biol. 23(3), 461-467.
25. Ryu, W. S., Bae, E.K., Park, S.H., Jeong, S.W., Schellingerhout, D., Nahrendorf, M., Kim, D.E., 2018. Increased Left Ventricular Filling Pressure and Arterial Occlusion in Stroke Related to Atrial Fibrillation. J. Stroke. Cerebrovasc. Dis. 27(5), 1275-1282.
26. Sahin, M., Bobusoglu, O., Yetim,A., Ates, F., 2019. Paraoxonase-1 and arylesterase levels in patients with ulcerative colitis. Arab. J. Gastroenterol. 20(1), 14-18.
27. Shenhar-Tsarfaty, S., Waiskopf, N., Ofek, K., Shopin, L., Usher, S., Berliner, S., Shapira, I., Bornstein, N.M., Ritov, Y., Soreq, H., Ben Assayag, E., 2013. Atherosclerosis and arteriosclerosis parameters in stroke patients associate with paraoxonase polymorphism and esterase activities. Eur. J. Neurol. 20(6), 891-898.
28. Touyz, R. M., Schiffrin, E.L., 2004. Reactive oxygen species in vascular biology: implications in hypertension. Histochem. Cell. Biol. 122(4), 339-352.
29. Wannamethee, S. G., Shaper, A.G., Ebrahim, S., 2000. HDL-Cholesterol, total cholesterol, and the risk of stroke in middle-aged British men. Stroke. 31(8), 1882-1888.
30. Wu, C. Y., Wu, H.M., Lee, J.D., Weng, H.H., 2010. Stroke risk factors and subtypes in different age groups: a hospital-based study. Neurol. India. 58(6), 863-868.