Literature DB >> 29877196

Clinical and Imaging Characteristics of Cerebral Infarction in Patients with Nonvalvular Atrial Fibrillation Combined with Cerebral Artery Stenosis.

Wei Sun1, Guangsheng Li1, Xiangjun Zeng1, Zhaohui Lai1, Mingqi Wang1, Yi Ouyang1, Guoyong Zeng1, Jidong Peng2, Junyuan Zhong2, Daoxiong Xiao2, Zhiping Huang3, Xiaofen Guo3.   

Abstract

AIMS: Nonvalvular atrial fibrillation often occurs in combination with carotid atherosclerosis, but less is known about it in combination with cerebral artery stenosis. This study investigated the characteristics of cerebral infarction in patients with nonvalvular atrial fibrillation with or without cerebral artery stenosis.
METHODS: A retrospective analysis was conducted on 172 cerebral infarction patients with nonvalvular atrial fibrillation hospitalized at the Affiliated Ganzhou Hospital of Nanchang University between December 2011 and January 2016. The patients were divided into two groups (stenosis and non-stenosis groups) based on whether the cerebral infarction was combined with cerebral artery stenosis or not. Clinical characteristics, related supplementary examination, and the imaging characteristics of cerebral infarction lesions were compared between the groups.
RESULTS: Mean age [(75.73±8.46) years vs. (63.44±9.95) years], National Institute of Health stroke scale (NIHSS) score [(8.66±6.73) vs. (4.59±3.51)], CHA2DS2-VASc score [(2.93±1.40) vs. (0.96±0.98)], history of hypertension (74.4% vs. 30.0%), and history of stroke/ transient ischemic attack (TIA) (55.8% vs. 13.3%) were higher in the stenosis group (n=107) than in the non-stenosis group (n=65) (P<0.01). In the stenosis group, there were different types of cerebral infarction lesions, including multiple infarction (multifocal type), massive infarction, watershed infarction, and lacunar infarction; in the non-stenosis group, the 60.0% lesions were multiple infarction (multifocal type), a significantly higher proportion than the stenosis group (26.2%, P<0.05). NIHSS score was an independent risk factor for worse prognosis at follow-up (OR (95%CI) 1.251-1.674, P<0.001).
CONCLUSIONS: Advanced age, hypertension, and stroke/TIA were increased in patients with cerebral infarction with nonvalvular atrial fibrillation combined with cerebral artery stenosis.

Entities:  

Keywords:  Cerebral artery stenosis; Cerebral infarction; Diffusion-weighted imaging; Nonvalvular atrial fibrillation

Mesh:

Year:  2018        PMID: 29877196      PMCID: PMC6099075          DOI: 10.5551/jat.43240

Source DB:  PubMed          Journal:  J Atheroscler Thromb        ISSN: 1340-3478            Impact factor:   4.928


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