Burden of intracranial artery calcification in white patients with ischemic stroke.

IF 5.8 3区 医学 Q1 CLINICAL NEUROLOGY
European Stroke Journal Pub Date : 2024-09-01 Epub Date: 2024-03-20 DOI:10.1177/23969873241239787
Bernhard P Berghout, Robin Yr Camarasa, Dianne Hk Van Dam-Nolen, Aad van der Lugt, Marleen de Bruijne, Peter J Koudstaal, M Kamran Ikram, Daniel Bos
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引用次数: 0

Abstract

Introduction: The diagnostic workup of stroke doesn't identify an underlying cause in two-fifths of ischemic strokes. Intracranial arteriosclerosis is acknowledged as a cause of stroke in Asian and Black populations, but is underappreciated as such in whites. We explored the burden of Intracranial Artery Calcification (IAC), a marker of intracranial arteriosclerosis, as a potential cause of stroke among white patients with recent ischemic stroke or TIA.

Patients and methods: Between December 2005 and October 2010, 943 patients (mean age 63.8 (SD ± 14.0) years, 47.9% female) were recruited, of whom 561 had ischemic stroke and 382 a TIA. CT-angiography was conducted according to stroke analysis protocols. The burden of IAC was quantified on these images, whereafter we assessed the presence of IAC per TOAST etiology underlying the stroke and assessed associations between IAC burden, symptom severity, and short-term functional outcome.

Results: IAC was present in 62.4% of patients. Furthermore, IAC was seen in 84.8% of atherosclerotic strokes, and also in the majority of strokes with an undetermined etiology (58.5%). Additionally, patients with larger IAC burden presented with heavier symptoms (adjusted OR 1.56 (95% CI [1.06-2.29]), but there was no difference in short-term functional outcome (1.14 [0.80-1.61]).

Conclusion: IAC is seen in the majority of white ischemic stroke patients, aligning with findings from patient studies in other ethnicities. Furthermore, over half of patients with a stroke of undetermined etiology presented with IAC. Assessing IAC burden may help identify the cause in ischemic stroke of undetermined etiology, and could offer important prognostic information.

缺血性脑卒中白人患者颅内动脉钙化的负担。
导言:五分之二的缺血性中风患者在中风的诊断检查中无法确定潜在病因。颅内动脉硬化被认为是亚裔和黑人中风的原因之一,但在白人中却未得到足够重视。颅内动脉钙化(IAC)是颅内动脉硬化的标志物,我们探讨了颅内动脉钙化作为近期缺血性中风或 TIA 的白人患者中风潜在病因的负担:2005 年 12 月至 2010 年 10 月间,共招募了 943 名患者(平均年龄 63.8(SD ± 14.0)岁,47.9% 为女性),其中 561 人患有缺血性中风,382 人患有 TIA。根据中风分析方案进行了 CT 血管造影。在这些图像上量化了 IAC 的负荷,然后我们根据 TOAST 病因评估了中风是否存在 IAC,并评估了 IAC 负荷、症状严重程度和短期功能预后之间的关联:结果:62.4%的患者存在 IAC。此外,84.8%的动脉粥样硬化性脑卒中和大多数病因不明的脑卒中(58.5%)都存在 IAC。此外,IAC负担较大的患者症状较重(调整后OR值为1.56(95% CI [1.06-2.29]),但短期功能预后无差异(1.14 [0.80-1.61]):结论:大多数白人缺血性卒中患者存在 IAC,这与其他种族患者的研究结果一致。此外,半数以上病因不明的卒中患者伴有 IAC。评估 IAC 负担有助于确定病因不明的缺血性卒中的病因,并可提供重要的预后信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.50
自引率
6.60%
发文量
102
期刊介绍: Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.
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