Chunyan Lei1, Bo Wu2, Ming Liu3, Yanchao Chen1. 1. Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Sichuan Province, People's Republic of China. 2. Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Sichuan Province, People's Republic of China; State Key Laboratory of Human Disease Biotherapy and Ministry of Education, West China Hospital, Sichuan University, Sichuan Province, People's Republic of China. Electronic address: dragonwbtxf@hotmail.com. 3. Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Sichuan Province, People's Republic of China; State Key Laboratory of Human Disease Biotherapy and Ministry of Education, West China Hospital, Sichuan University, Sichuan Province, People's Republic of China.
Abstract
BACKGROUND: The aim of this study was to investigate differences in risk factors, lipid profiles, mortality, and poor functional outcome in the long term in patients who had stroke associated with intracranial and/or extracranial atherosclerotic stenosis. METHODS: We consecutively and prospectively enrolled patients admitted to our hospital with acute ischemic stroke. Included patients were classified into 4 groups based on stroke subtype: noncerebral artery stenosis (NCAS), intracranial stenosis (IS), extracranial stenosis (ES), and combined intracranial and extracranial stenosis (IES). Risk factors, lipid profiles, mortality, and poor functional outcome in the long term were compared among the stenosis subtypes. RESULTS: In total, 1196 patients were included in the analysis. Independent IS markers were found to be diabetes mellitus (odds ratio [OR] 1.41, 95% confidence interval [CI] 1.08-1.80, P = .01) and low-density lipoprotein (LDL) of 2.6 mmol/L or more at admission (OR 3.48, 95% CI 2.69-4.50, P < .01). Factors that increased risk for ES and IES were male gender (ES, OR 2.26, 95% CI 1.29-3.98, P < .01; IES, OR 1.65, 95% CI 1.08-2.53, P = .02), older age (ES, OR 1.03, 95% CI 1.01-1.05, P = .02; IES, OR 1.03, 95% CI 1.01-1.04, P < .01), and LDL of 2.6 mmol/L or more (ES, OR 1.74, 95% CI 1.05-2.88, P = .03; IES, OR 2.08, 95% CI 1.36-3.18, P < .01). Poor functional outcome and mortality were significantly more frequent in the IS and IES groups than in the NCAS group at 3 months and 1 year after discharge. CONCLUSIONS: Patients with IS and IES were at higher risk of poor functional outcome and mortality than were patients with NCAS. Risk factors and lipid profiles differed among the stenosis subtypes. Thus, targeted strategies may need to take these differences into account to prevent or manage poor functional outcomes and mortality.
BACKGROUND: The aim of this study was to investigate differences in risk factors, lipid profiles, mortality, and poor functional outcome in the long term in patients who had stroke associated with intracranial and/or extracranial atherosclerotic stenosis. METHODS: We consecutively and prospectively enrolled patients admitted to our hospital with acute ischemic stroke. Included patients were classified into 4 groups based on stroke subtype: noncerebral artery stenosis (NCAS), intracranial stenosis (IS), extracranial stenosis (ES), and combined intracranial and extracranial stenosis (IES). Risk factors, lipid profiles, mortality, and poor functional outcome in the long term were compared among the stenosis subtypes. RESULTS: In total, 1196 patients were included in the analysis. Independent IS markers were found to be diabetes mellitus (odds ratio [OR] 1.41, 95% confidence interval [CI] 1.08-1.80, P = .01) and low-density lipoprotein (LDL) of 2.6 mmol/L or more at admission (OR 3.48, 95% CI 2.69-4.50, P < .01). Factors that increased risk for ES and IES were male gender (ES, OR 2.26, 95% CI 1.29-3.98, P < .01; IES, OR 1.65, 95% CI 1.08-2.53, P = .02), older age (ES, OR 1.03, 95% CI 1.01-1.05, P = .02; IES, OR 1.03, 95% CI 1.01-1.04, P < .01), and LDL of 2.6 mmol/L or more (ES, OR 1.74, 95% CI 1.05-2.88, P = .03; IES, OR 2.08, 95% CI 1.36-3.18, P < .01). Poor functional outcome and mortality were significantly more frequent in the IS and IES groups than in the NCAS group at 3 months and 1 year after discharge. CONCLUSIONS:Patients with IS and IES were at higher risk of poor functional outcome and mortality than were patients with NCAS. Risk factors and lipid profiles differed among the stenosis subtypes. Thus, targeted strategies may need to take these differences into account to prevent or manage poor functional outcomes and mortality.
Authors: Claudia K Suemoto; Lea T Grinberg; Renata E P Leite; Renata E L Ferretti-Rebustini; Wilson Jacob-Filho; Kristine Yaffe; Ricardo Nitrini; Carlos A Pasqualucci Journal: Atherosclerosis Date: 2017-12-09 Impact factor: 5.162