Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

Journal：Neurological sciences

Publication type: Article

IF(IF): 3.3

PMID: 35364769 Link To Pubmed Full text Download

Multilpe acute infractions (MAIs) has been reported that it was associated with the recurrence of acute ischemic stroke(AIS) and transient ischemic attack (TIA). Previous studies have reported multiple acute infractions (MAIs) usually had higher risk of stroke recurrence than single acute infarction(SAI) and no acute infarction(NAI) in minor stroke and transient ischemic attack. And the association of cerebral small vessel disease(CSVD) with the recurrence and prognosis of acute ischemic stroke(AIS) has been proved. However, among patients after stroke, it is lack studies about the relationship of CSVD and infraction patterns in patients. In this pre-specified imaging substudy of the CHANCE trial, we aim to investigate the roles of CSVD and infraction numbers on different outcomes (i.e. new stroke, modified Rankin Scale [mRS], and any bleeding event) at 1-year follow-up in patients with minor stroke and TIA.

This study was a post hoc analysis of the Clopidogrel in High-risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial, and includes 886 patients with acute minor stroke and TIA. The status of CSVD and infarction number was recorded for each individual. Infarction number were classified as multiple acute infarctions (MAIs≥2), single acute infarction (SAI =1), and non-acute infarction (NAI =0). The CSVD burden were grouped into non-CSVD (0 score) and CSVD (1-4 score). The primary outcome was a recurrent stroke at the 1-year follow-up. The secondary outcomes were recurrent ischaemic stroke, composite vascular event (CVE), and TIA. We analyzed the relationships between different status of CSVD burden and infarction pattern with the risk of outcomes using multivariable Cox regression models.