BACKGROUND: Apolipoprotein A1 (ApoA1), which is a structural protein of high-density lipoprotein cholesterol, may be associated with the generative pathology of ischemic stroke. The aim of this study was to investigate ApoA1 and carotid artery ultrasonography findings among ischemic stroke subtypes and control.
METHODS:
We enrolled a total of 86 patients with stroke and age matched controls (CONT, n=20). The stroke patients were divided into 3 subtypes: cardio-embolic infarction (CE, n=13), atherothrombotic infarction (ATBI, n=36), lacunar infarction (LI, n=17). We measured the total number and plaque thickness and the carotid intima-media thickness (IMT), which is a surrogate marker of subclinical atherosclerosis, at the common carotid artery (CCA), carotid bifurcation (BIF), and internal carotid artery (ICA) using B-mode ultrasound. Carotid plaques were classified into 4 types: low, intermediate, high intensity, and mixed. Serum lipids (TC, LDL-C, HDL-C, TG), apolipoproteins (A1, A2, B, C2, and E), RLP-C, MDA-LDL were analyzed using commercially available kits.
RESULTS:
There was no difference in TC, LDL-C, HDL-C, TG levels among 4 groups, and controlled by statin drugs. Serum ApoA1 levels in the ATBI group were significantly lower compared with CE, LI and CONT groups. The plaque thickness in BIF and ICA and the total number of plaques in CCA in the ATBI group were significantly higher than compared with CE, LI and CONT groups. 
CONCLUSIONS:
These findings suggest that patients with ATBI had a lot of and thick plaques at carotid artery and serum ApoA1 levels might be associated with the development of ATBI.

Comparison of apolipoprotein A1 and carotid artery ultrasonography findings among stroke subtypes and controls