Intracranial Arterial Calcification Relates to Long-Term Risk of Recurrent Stroke and Post-stroke Mortality
| Autor: | Xiaohong Wu, Daniel Bos, Lijie Ren, Thomas Wai-hong Leung, Winnie Chiu-Wing Chu, Lawrence Ka Sing Wong, Jill Abrigo, Xiang Yan Chen |
|---|---|
| Přispěvatelé: | Epidemiology, Radiology & Nuclear Medicine |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Stroke recurrence stroke recurrence Disease 030204 cardiovascular system & hematology Agatston score lcsh:RC346-429 post-stroke mortality 03 medical and health sciences 0302 clinical medicine Recurrent stroke Internal medicine intracranial arterial calcification Medicine cardiovascular diseases Risk factor Stroke lcsh:Neurology. Diseases of the nervous system Original Research business.industry medicine.disease stroke Arterial calcification Neurology Cardiology Neurology (clinical) atherosclerosis business 030217 neurology & neurosurgery Calcification |
| Zdroj: | Frontiers in Neurology, Vol 11 (2020) Frontiers in Neurology Frontiers in Neurology, 11:559158. Frontiers Media S.A. |
| ISSN: | 1664-2295 |
| Popis: | Background: Intracranial arterial calcification (IAC) is highly prevalent in ischemic stroke patients. However, data on the association of IAC with stroke recurrence and mortality remains limited. We examined the effect of IAC on the long-term recurrence of stroke and the risk of post-stroke mortality. Methods: Using a prospective stroke registry, we recruited 694 patients (mean age 71.6 ± 12.4; male sex 50.3%) since December 2004. IAC was visualized using the computed tomography exam that was made at hospital admission and was quantified with the Agatston method. All patients were regularly followed up till July 2016. The impacts of IAC on stroke recurrence and mortality were assessed using Cox-regression models with adjustments for age, sex, and relevant cardiovascular risk factors. Results: During a median follow-up period of 8.8 years, 156 patients (22.5%) suffered a recurrent stroke and 84 died (12.1%). We found that a higher IAC Agatston score related to a higher risk of stroke recurrence (HR per 1-SD increase in IAC: 1.30; 95% CI, 1.08–1.56, p = 0.005) and a higher risk of post-stroke mortality (HR per 1-SD increase, 1.44; 95% CI, 1.06–1.96, p = 0.019). After investigating etiology-specific risks of stroke-recurrence, we found that a higher IAC Agatston score specifically associated with small-vessel occlusive stroke. Conclusions: IAC is a strong risk factor for recurrent stroke and post-stroke mortality. Among stroke subtypes, IAC relates to higher risk of stroke recurrence among patients with small-vessel disease, which indicates chronic calcification detected in large cerebral arteries may have potential effects on the cerebrovascular beds extending to small vessels. |
| Databáze: | OpenAIRE |
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