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 |
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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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