Clinical and Genetic Risk Factors of Long-Term Outcomes after Encephaloduroarteriosynangiosis in Moyamoya Disease in China
| Autor: | Hui Wang, Yuetian Yang, Lanxin Ou, Desheng Li, Mengke Shang, Man Liang, Lian Duan, Lu Wen, Xiaotong Wang, Rimiao Yang, Cong Han, Na Ta, Xiang-Yang Bao, Zhibin Yang, Wanyang Liu, Yue Wang, Fangbin Hao, Fangfang Nie, Zhengxing Zou, Zheng-Shan Zhang, Fanxin Zeng |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty China Time Factors Adolescent Ubiquitin-Protein Ligases Posterior cerebral artery Risk Assessment 03 medical and health sciences Young Adult 0302 clinical medicine Postoperative Complications Risk Factors medicine.artery Diabetes mellitus Internal medicine Medicine Humans Genetic Predisposition to Disease Moyamoya disease Genetic risk Stroke Genetic Association Studies Retrospective Studies Adenosine Triphosphatases Polymorphism Genetic Cerebral Revascularization business.industry Proportional hazards model Rehabilitation Retrospective cohort study medicine.disease Treatment Outcome EDAS Surgery Female Neurology (clinical) Moyamoya Disease Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery |
| Zdroj: | Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 30(7) |
| ISSN: | 1532-8511 |
| Popis: | This retrospective study was conducted to analyze the associations between ring finger protein 213 p.R4810K variant, clinical features and long-term outcomes in patients with moyamoya disease (MMD) after encephaloduroarteriosynangiosis treatment.A total of 2,545 patients with MMD in China were included in this study (median of follow-up duration: 32.00 months). Multiple Cox regression models were used to assess the associations between p.R4810K variant, clinical features and long-term outcomes.For all patients, in multivariate Cox analysis, no association was observed between p.R4810K and long-term outcomes. Pediatric onset (HR, 0.38; 95%CI, 0.25-0.59) and headache (HR, 0.26; 95%CI, 0.08-0.83) were inversely and hypertension (HR, 1.43 95%CI, 1.06-1.94), diabetes (HR, 1.55; 95%CI, 1.00-2.40), bilateral lesions (HR, 2.73; 95%CI, 1.12-6.65) and posterior cerebral artery involvement (HR, 1.44; 95%CI, 1.08-1.90) were positively associated with follow-up stroke (all P0.05). Pediatric onset (HR, 0.46; 95%CI, 0.26-0.82) was inversely and hyperlipidemia (HR, 1.83; 95%CI, 1.23-2.73), smoking (HR, 1.86; 95%CI, 1.13-3.07), high Suzuki angiographic stage (HR, 1.71, 95%CI, 1.09-2.70), poor admission neurologic status (HR, 8.93; 95%CI, 6.49-12.29) and follow-up stroke (HR, 8.31; 95%CI, 6.01-11.49) were positively associated with poor neurologic outcome at the last follow-up visit (all P0.05). The factors were not consistent in the different groups of age at onset.In our study, p.R4810K may play no role in long-term outcomes in Chinese MMD. Clinical features including age at onset, initial symptoms, risk factors of stroke, imaging, poor admission neurologic status were associated with poor outcomes in MMD after EDAS. |
| Databáze: | OpenAIRE |
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