Baseline Characteristics of Patients with Symptomatic Carotid Webs: A Matched Case Control Study
| Autor: | Song Julia Kim, Nicolas Bianchi, Leonardo Pisani, Michael Frankel, Alhamza R. Al-Bayati, Raul G Nogueira, Fadi Nahab, Mehdi Bouslama, Catarina Perry da Camara, Diogo C Haussen, David Landzberg |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Carotid Artery Diseases Male medicine.medical_specialty Databases Factual Fibromuscular dysplasia Risk Assessment White People 03 medical and health sciences 0302 clinical medicine Sex Factors Risk Factors Internal medicine medicine Fibromuscular Dysplasia Humans In patient Stroke Cerebrovascular risk Ischemic Stroke medicine.diagnostic_test business.industry Rehabilitation Case-control study Middle Aged medicine.disease Prognosis Race Factors Black or African American Baseline characteristics Case-Control Studies Etiology Surgery Female Neurology (clinical) Cardiology and Cardiovascular Medicine Lipid profile business 030217 neurology & neurosurgery |
| Zdroj: | Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 30(8) |
| ISSN: | 1532-8511 |
| Popis: | Background and purpose The baseline characteristics of patients with symptomatic carotid web (CaW) are unclear. We investigate demographic and cerebrovascular risk factors in patients with this overlooked stroke etiology. Methods We identified consecutive patients diagnosed with symptomatic CaW at a comprehensive stroke center from July 2014-December 2018. These patients were matched at a 1:4 ratio (based on age and NIHSS scores) to create a control group of acute ischemic stroke (AIS) patients with non-CaW etiologies from the local GetWithTheGuidelines stroke database. Results Thirty patients with symptomatic CaW were compared to 120 AIS patients with non-CaW etiologies. Symptomatic CaW patients were more likely to be female (73.3 vs. 44.2%; p = 0.004) and black (86.7 vs. 64.2%; p = 0.02). Symptomatic CaWs patients had a fewer absolute number of modifiable cerebrovascular risk factors (1.7±1.1 vs. 2.5±1.2; p = 0.002), lower rates of hypertension (43.4 vs. 63.3%; p = 0.04), and a more favorable lipid profile with lower average LDL (89.5±30.3 vs. 111.2±43.7 mg/dL; p = 0.01) and higher average HDL (47.9±11.3 vs. 42.2±13.8 mg/dL; p = 0.01) as compared to strokes with non-CaW etiology. Symptomatic CaW patients were more likely to have a large vessel occlusion (80.0 vs. 51.7%; p = 0.005), despite similar e-ASPECTS between the groups (8.1±2.1 vs. 8.3±2.2; p = 0.30). On multivariable analysis, symptomatic CaW was an independent predictor of independence at discharge (OR 3.72; 95%CI 1.27–10.94). Conclusion A gender and racial predilection of symptomatic CaWs may exist as females and blacks were were found to be more likely affected. Symptomatic CaW patients have a more benign cerebrovascular risk factor profile corroborating the proposed mechanism of local stasis and thromboembolism. Despite presenting more commonly with LVO, symptomatic CaW was associated with good functional outcome, warranting further studies. |
| Databáze: | OpenAIRE |
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