Jose C Navarro, Jeyaraj D Pandian, Nijasri C Suwanwela, Tsong-Hai Lee, Kay Sin Tan, Narayanaswamy Venketasubramanian
{"title":"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。","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":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>This is an international, multicentre, observational, prospective cohort study of patients admitted with acute ischemic stroke secondary to ICAS to stroke centres 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 was collected on patient demographics, vascular risk factors, stroke location and severity. Outcomes of interest were stroke recurrence and mortality at 12-month follow-up.</p><p><strong>Results: </strong>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 one 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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":45709,"journal":{"name":"Cerebrovascular Diseases Extra","volume":" ","pages":"1-16"},"PeriodicalIF":2.0000,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Outcomes of Symptomatic Intracranial Large Artery Stenoses: a Prospective Cohort Study from The Asian Registry of Intracranial Atherosclerosis (ARICAS).\",\"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\":\"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>This is an international, multicentre, observational, prospective cohort study of patients admitted with acute ischemic stroke secondary to ICAS to stroke centres 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 was collected on patient demographics, vascular risk factors, stroke location and severity. Outcomes of interest were stroke recurrence and mortality at 12-month follow-up.</p><p><strong>Results: </strong>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 one 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).</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":45709,\"journal\":{\"name\":\"Cerebrovascular Diseases Extra\",\"volume\":\" \",\"pages\":\"1-16\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-12-19\",\"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\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","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":"","PubModel":"","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
Outcomes of Symptomatic Intracranial Large Artery Stenoses: a Prospective Cohort Study from The Asian Registry of Intracranial Atherosclerosis (ARICAS).
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, multicentre, observational, prospective cohort study of patients admitted with acute ischemic stroke secondary to ICAS to stroke centres 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 was 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 one 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.
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.
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