Cerebral small vessel disease or intracranial large vessel atherosclerosis may carry different risk for future strokes

Autor: Lixia Zong, Liping Liu, Hao Li, Yu-Yuan Xu, Jing Jing, Xingquan Zhao, Huimin Chen, Hongyi Yan, Xia Meng, Yongjun Wang, Yuesong Pan, Yilong Wang, S. Claiborne Johnston
Rok vydání: 2020
Předmět:
Male
China
medicine.medical_specialty
Hemorrhage
Large vessel
Disease
030204 cardiovascular system & hematology
intracranial arterial stenosis
Risk Assessment
Disability Evaluation
03 medical and health sciences
0302 clinical medicine
Double-Blind Method
Risk Factors
Modified Rankin Scale
Internal medicine
medicine
Humans
cardiovascular diseases
Stroke
Aged
Original Research
cerebral small vessel disease
Proportional hazards model
Arterial stenosis
business.industry
Middle Aged
Intracranial Arteriosclerosis
Prognosis
medicine.disease
Clopidogrel
stroke
Cerebral Angiography
Diffusion Magnetic Resonance Imaging
Ischemic Attack
Transient

Cerebral Small Vessel Diseases
Cardiology
Female
Neurology (clinical)
Small vessel
Cardiology and Cardiovascular Medicine
business
Magnetic Resonance Angiography
Platelet Aggregation Inhibitors
030217 neurology & neurosurgery
medicine.drug
Zdroj: Stroke and Vascular Neurology
ISSN: 2059-8696
2059-8688
0097-9589
DOI: 10.1136/svn-2019-000305
Popis: BackgroundThe effect of cerebral small vessel disease (CSVD) and intracranial arterial stenosis (ICAS) on stroke outcomes remains unclear.MethodsData of 1045 patients with minor stroke or transient ischaemic attack (TIA) were obtained from 45 sites of the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. We assessed the associations of burdens of CSVD and ICAS with new strokes and bleeding events using multivariate Cox regression models and those with modified Rankin Scale (mRS) scores using ordinal logistic regression models.ResultsAmong the 1045 patients, CSVD was present in 830 cases (79.4%) and ICAS in 460 (44.0%). Patients with >1 ICAS segment showed the highest risk of new strokes (HR 2.03, 95% CI 1.15 to 3.56, p=0.01). No association between CSVD and the occurrence of new strokes was found. The presence of severe CSVD (common OR (cOR) 2.01, 95% CI 1.40 to 2.89, p1 ICAS segment (cOR 2.15, 95% CI 1.57 to 2.93, pInterpretationCSVD is associated with more disability and bleeding events, and ICAS is associated with an increased risk of stroke and disability in patients with minor stroke and TIA at 3 months. CSVD and ICAS may represent different vascular pathologies and play distinct roles in stroke outcomes.Trial registration numberNCT00979589
Databáze: OpenAIRE
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