RATIONALE: Lacunar infarct associated with small vessel disease is a common stroke subtype in China and has a favorable short-term prognosis. Data on its long-term prognosis among Chinese patients are lacking. AIMS: We aimed to study its long-term prognosis and predictors for poor outcomes. DESIGN: We followed up to 75 consecutive Chinese stroke patients who had a lacunar infarct for a period of 5 years. Clinical outcomes with respect to mortality and recurrent stroke were noted. We evaluated baseline clinical and imaging predictors for such outcomes using the Cox regression analysis. STUDY OUTCOMES: Sixteen (21.3%) patients died and 12 (16%) patients had recurrent stroke during follow-up. Twenty-one (28%) patients had combined events of either death and/or recurrent stroke. Univariate Cox regression analysis showed that age, literacy, National Institute of Health Stroke Scale, incident stroke/transient ischemic attack, and white matter lesion volume predicted survival, while, age, National Institute of Health Stroke Scale, systolic blood pressure, hyperhomocysteinemia, silent lacunes, microbleeds, and white matter lesion volume predicted recurrent stroke. Multivariate Cox regression analysis showed that National Institute of Health Stroke Scale (HR 1.25, 95% CI 1.05-1.48) and white matter lesion volume (HR 1.46, 95% CI 1.11-1.92) predicted combined events of mortality and/or recurrent stroke after age adjustment. CONCLUSION: Approximately one in four patients either died and/or had recurrent stroke within 5 years after a lacunar infarct. Age, stroke severity, and volume of white matter lesion predict a poor long-term prognosis.
RATIONALE: Lacunar infarct associated with small vessel disease is a common stroke subtype in China and has a favorable short-term prognosis. Data on its long-term prognosis among Chinese patients are lacking. AIMS: We aimed to study its long-term prognosis and predictors for poor outcomes. DESIGN: We followed up to 75 consecutive Chinese strokepatients who had a lacunar infarct for a period of 5 years. Clinical outcomes with respect to mortality and recurrent stroke were noted. We evaluated baseline clinical and imaging predictors for such outcomes using the Cox regression analysis. STUDY OUTCOMES: Sixteen (21.3%) patients died and 12 (16%) patients had recurrent stroke during follow-up. Twenty-one (28%) patients had combined events of either death and/or recurrent stroke. Univariate Cox regression analysis showed that age, literacy, National Institute of Health Stroke Scale, incident stroke/transient ischemic attack, and white matter lesion volume predicted survival, while, age, National Institute of Health Stroke Scale, systolic blood pressure, hyperhomocysteinemia, silent lacunes, microbleeds, and white matter lesion volume predicted recurrent stroke. Multivariate Cox regression analysis showed that National Institute of Health Stroke Scale (HR 1.25, 95% CI 1.05-1.48) and white matter lesion volume (HR 1.46, 95% CI 1.11-1.92) predicted combined events of mortality and/or recurrent stroke after age adjustment. CONCLUSION: Approximately one in four patients either died and/or had recurrent stroke within 5 years after a lacunar infarct. Age, stroke severity, and volume of white matter lesion predict a poor long-term prognosis.
Authors: Robert G Hart; Lesly A Pearce; Majid F Bakheet; Oscar R Benavente; Robin A Conwit; Leslie A McClure; Robert L Talbert; David C Anderson Journal: J Stroke Cerebrovasc Dis Date: 2013-06-22 Impact factor: 2.136
Authors: Ashkan Shoamanesh; Lesly A Pearce; Carlos Bazan; Luciana Catanese; Leslie A McClure; Mukul Sharma; Joan Marti-Fabregas; David C Anderson; Carlos S Kase; Robert G Hart; Oscar R Benavente Journal: Ann Neurol Date: 2017-07-19 Impact factor: 10.422
Authors: Duncan Wilson; Gareth Ambler; Keon-Joo Lee; Jae-Sung Lim; Masayuki Shiozawa; Masatoshi Koga; Linxin Li; Caroline Lovelock; Hugues Chabriat; Michael Hennerici; Yuen Kwun Wong; Henry Ka Fung Mak; Luis Prats-Sánchez; Alejandro Martínez-Domeño; Shigeru Inamura; Kazuhisa Yoshifuji; Ethem Murat Arsava; Solveig Horstmann; Jan Purrucker; Bonnie Yin Ka Lam; Adrian Wong; Young Dae Kim; Tae-Jin Song; Maarten Schrooten; Robin Lemmens; Sebastian Eppinger; Thomas Gattringer; Ender Uysal; Zeynep Tanriverdi; Natan M Bornstein; Einor Ben Assayag; Hen Hallevi; Jun Tanaka; Hideo Hara; Shelagh B Coutts; Lisa Hert; Alexandros Polymeris; David J Seiffge; Philippe Lyrer; Ale Algra; Jaap Kappelle; Rustam Al-Shahi Salman; Hans R Jäger; Gregory Y H Lip; Heinrich P Mattle; Leonidas D Panos; Jean-Louis Mas; Laurence Legrand; Christopher Karayiannis; Thanh Phan; Sarah Gunkel; Nicolas Christ; Jill Abrigo; Thomas Leung; Winnie Chu; Francesca Chappell; Stephen Makin; Derek Hayden; David J Williams; M Eline Kooi; Dianne H K van Dam-Nolen; Carmen Barbato; Simone Browning; Kim Wiegertjes; Anil M Tuladhar; Noortje Maaijwee; Christine Guevarra; Chathuri Yatawara; Anne-Marie Mendyk; Christine Delmaire; Sebastian Köhler; Robert van Oostenbrugge; Ying Zhou; Chao Xu; Saima Hilal; Bibek Gyanwali; Christopher Chen; Min Lou; Julie Staals; Régis Bordet; Nagaendran Kandiah; Frank-Erik de Leeuw; Robert Simister; Aad van der Lugt; Peter J Kelly; Joanna M Wardlaw; Yannie Soo; Felix Fluri; Velandai Srikanth; David Calvet; Simon Jung; Vincent I H Kwa; Stefan T Engelter; Nils Peters; Eric E Smith; Yusuke Yakushiji; Dilek Necioglu Orken; Franz Fazekas; Vincent Thijs; Ji Hoe Heo; Vincent Mok; Roland Veltkamp; Hakan Ay; Toshio Imaizumi; Beatriz Gomez-Anson; Kui Kai Lau; Eric Jouvent; Peter M Rothwell; Kazunori Toyoda; Hee-Joon Bae; Joan Marti-Fabregas; David J Werring Journal: Lancet Neurol Date: 2019-05-23 Impact factor: 59.935
Authors: Duncan Wilson; Andreas Charidimou; Gareth Ambler; Zoe V Fox; Simone Gregoire; Phillip Rayson; Toshio Imaizumi; Felix Fluri; Hiromitsu Naka; Solveig Horstmann; Roland Veltkamp; Peter M Rothwell; Vincent I H Kwa; Vincent Thijs; Yong-Seok Lee; Young Dae Kim; Yining Huang; Ka Sing Wong; Hans Rolf Jäger; David J Werring Journal: Neurology Date: 2016-09-02 Impact factor: 9.910