Outcomes of Symptomatic Intracranial Large Artery Stenoses: A Prospective Cohort Study from the Asian Registry of Intracranial Atherosclerosis.

IF 2 Q3 PERIPHERAL VASCULAR DISEASE

Cerebrovascular Diseases Extra Pub Date : 2025-01-01 Epub Date: 2024-12-19 DOI:10.1159/000543144

Jose C Navarro, Jeyaraj D Pandian, Nijasri C Suwanwela, Tsong-Hai Lee, Kay Sin Tan, Narayanaswamy Venketasubramanian

{"title":"Outcomes of Symptomatic Intracranial Large Artery Stenoses: A Prospective Cohort Study from the Asian Registry of Intracranial Atherosclerosis.","authors":"Jose C Navarro, Jeyaraj D Pandian, Nijasri C Suwanwela, Tsong-Hai Lee, Kay Sin Tan, Narayanaswamy Venketasubramanian","doi":"10.1159/000543144","DOIUrl":null,"url":null,"abstract":"Introduction: Intracranial large artery atherosclerosis (ICAS) is a common cause of stroke in Asia. Prior epidemiological publications on ICAS have largely been single-country reports. This collaborative study involving several Asian countries aims to investigate the characteristics and outcomes of patients with stroke attributable to ICAS.Methods: This is an international, multicenter, observational, prospective cohort study of patients admitted with acute ischemic stroke secondary to ICAS to stroke centers in six Asian countries. Stroke due to ICAS was diagnosed when there was a ≥50% intracranial large artery stenosis ipslateral to a non-lacunar infarct, without significant ipsilateral extracranial stenosis, cardiac cause or other mechanism found for the stroke. Data were collected on patient demographics, vascular risk factors, stroke location, and severity. Outcomes of interest were stroke recurrence and mortality at 12-month follow-up.Results: A total of 356 patients were recruited. Mean age was 62.7 ± 13.8 years, and 39.9% were females. Mean NIHSS on admission was 9 ± 8, with majority of patients having mild (39.3%) or moderate (37.9%) strokes. Stroke recurrence was 6.7% (95% CI: 4.4-9.9%) while mortality rate was 13.2% (95% CI: 9.9-17.2%) within 1 year. The risk of stroke recurrence was associated with increasing age (odds ratio [OR]: 1.04, 95% CI: 1-1.06, p = 0.05) and hypertension (OR: 3.23, 95% CI: 1.09-9.61, p = 0.035). Mortality was associated with age (OR: 1.05, 95% CI: 1.01-1.08, p = 0.006) and NIHSS (OR: 1.12, 95% CI: 1.07-1.17, p < 0.001).Conclusions: This multicenter Asian study demonstrates a high risk of stroke recurrence and mortality among patients with acute stroke due to ICAS. They are associated with age (both), as well as hypertension (for recurrence) and NIHSS (for mortality). Better treatment modalities are needed to reduce the frequency of adverse outcomes in symptomatic ICAS.","PeriodicalId":45709,"journal":{"name":"Cerebrovascular Diseases Extra","volume":" ","pages":"30-38"},"PeriodicalIF":2.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cerebrovascular Diseases Extra","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000543144","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/19 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Intracranial large artery atherosclerosis (ICAS) is a common cause of stroke in Asia. Prior epidemiological publications on ICAS have largely been single-country reports. This collaborative study involving several Asian countries aims to investigate the characteristics and outcomes of patients with stroke attributable to ICAS.

Methods: This is an international, multicenter, observational, prospective cohort study of patients admitted with acute ischemic stroke secondary to ICAS to stroke centers in six Asian countries. Stroke due to ICAS was diagnosed when there was a ≥50% intracranial large artery stenosis ipslateral to a non-lacunar infarct, without significant ipsilateral extracranial stenosis, cardiac cause or other mechanism found for the stroke. Data were collected on patient demographics, vascular risk factors, stroke location, and severity. Outcomes of interest were stroke recurrence and mortality at 12-month follow-up.

Results: A total of 356 patients were recruited. Mean age was 62.7 ± 13.8 years, and 39.9% were females. Mean NIHSS on admission was 9 ± 8, with majority of patients having mild (39.3%) or moderate (37.9%) strokes. Stroke recurrence was 6.7% (95% CI: 4.4-9.9%) while mortality rate was 13.2% (95% CI: 9.9-17.2%) within 1 year. The risk of stroke recurrence was associated with increasing age (odds ratio [OR]: 1.04, 95% CI: 1-1.06, p = 0.05) and hypertension (OR: 3.23, 95% CI: 1.09-9.61, p = 0.035). Mortality was associated with age (OR: 1.05, 95% CI: 1.01-1.08, p = 0.006) and NIHSS (OR: 1.12, 95% CI: 1.07-1.17, p < 0.001).

Conclusions: This multicenter Asian study demonstrates a high risk of stroke recurrence and mortality among patients with acute stroke due to ICAS. They are associated with age (both), as well as hypertension (for recurrence) and NIHSS (for mortality). Better treatment modalities are needed to reduce the frequency of adverse outcomes in symptomatic ICAS.

查看原文本刊更多论文

无症状颅内大动脉狭窄的预后：来自亚洲颅内动脉粥样硬化登记处（ARICAS）的前瞻性队列研究。

颅内大动脉粥样硬化（ICAS）是亚洲中风的常见原因。以前关于ICAS的流行病学出版物大多是单一国家的报告。这项涉及多个亚洲国家的合作研究旨在调查由ICAS引起的脑卒中患者的特征和结果。方法：这是一项国际、多中心、观察性、前瞻性队列研究，研究对象是6个亚洲国家卒中中心收治的继发于ICAS的急性缺血性卒中患者。当颅内大动脉狭窄与非腔隙性梗死同侧同时出现bbb50 %颅内大动脉狭窄时，诊断为ICAS所致卒中，未发现明显的同侧颅外狭窄、心脏原因或其他机制导致卒中。收集了患者人口统计学、血管危险因素、中风部位和严重程度的数据。随访12个月后的结果为卒中复发率和死亡率。结果：共纳入356例患者。平均年龄62.7岁13.8岁，女性占39.9%。入院时NIHSS平均值为9 + 8，大多数患者为轻度（39.3%）或中度（37.9%）卒中。1年内卒中复发率为6.7% (95%CI 4.4 ~ 9.9%)，死亡率为13.2% （95%CI 9.9 ~ 17.2%）。卒中复发风险与年龄增加（比值比OR 1.04, 95%CI 1 ~ 1.06, p = 0.05）和高血压（比值比OR 3.23, 95%CI 1.09 ~ 9.61, p = 0.035）相关。死亡率与年龄（OR 1.05, 95%CI 1.01 - 1.08, p = 0.006）和NIHSS （OR 1.12, 95%CI 1.07 - 1.17, p）相关。结论：这项亚洲多中心研究表明，ICAS导致的急性卒中患者卒中复发和死亡率风险较高。它们与年龄（两者）、高血压（复发）和NIHSS（死亡率）有关。需要更好的治疗方式来减少症状性ICAS不良后果的发生频率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Cerebrovascular Diseases Extra PERIPHERAL VASCULAR DISEASE-

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

8 weeks

期刊介绍： This open access and online-only journal publishes original articles covering the entire spectrum of stroke and cerebrovascular research, drawing from a variety of specialties such as neurology, internal medicine, surgery, radiology, epidemiology, cardiology, hematology, psychology and rehabilitation. Offering an international forum, it meets the growing need for sophisticated, up-to-date scientific information on clinical data, diagnostic testing, and therapeutic issues. The journal publishes original contributions, reviews of selected topics as well as clinical investigative studies. All aspects related to clinical advances are considered, while purely experimental work appears only if directly relevant to clinical issues. Cerebrovascular Diseases Extra provides additional contents based on reviewed and accepted submissions to the main journal Cerebrovascular Diseases.