国家神经系统疾病临床医学研究中心数据管理与共享系统
Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Extracranial Carotid Plaque Hemorrhage Is Independently Associated with Poor 3-month Functional Outcome after Acute Ischemic Stroke-A Prospective Cohort Study
第一作者：Fengli Che
通讯作者：Xingquan Zhao
基本信息
- 负责人：Fengli Che
- 数据来源： OTHERS
- 论文编号：OTHERS20210206
- 发表时间：2021-12-14
2021-12-14
已发表文章
发表杂志：Frontiers in Neurology
发表类型: Original Contributions
影响因子(IF): 4.003
PMID: 34970212 Pubmed原文链接 全文下载
主要研究背景及目的
Carotid plaque hemorrhage (IPH) is a critical plaque vulnerable feature. We aim to elucidate the association between symptomatic extracranial carotid atherosclerotic IPH and poor 3-month functional outcome after acute ischemic stroke by high-resolution vessel wall MRI (HRVMRI).
方法
We prospectively studied consecutive patients with a recent stroke or transient ischemic attack(TIA) of carotid atherosclerotic origin. All patients underwent an HR VWMRI scan of ipsilateral extracranial carotid within one week after admission. Patients recruited were interviewed by telephone at 3-month after stroke onset. The primary outcome was a 3-month functional prognosis of stroke, expressed as a modified Rankin Scale (mRS) score. A poor prognosis was defined as a 3-month mRS score ≥ of 3. Univariate analysis was used to analyze the correlation between risk factors and IPH. The relation between IPH and 3-month functional outcome was analyzed by Logistic regression analysis.
结论
Extracranial carotid IPH is significantly associated with poor 3-month outcome after acute ischemic stroke and can predict the poor 3-month functional prognosis.
主要结果
A total of 156 patients (mean age, 61.18±10.12 years; 108 males) were included in the final analysis. There were significant differences in the age, gender, smoking history, national institutes of health stroke scale (NIHSS) on admission, diastolic blood pressure (DBP) on admission between the IPH group and the non-IPH group (all p<0.05). During the follow-up, 32 patients (20.5%) had a poor functional outcome. According to the prognosis analysis of poor functional recovery, there was a significant difference between the two groups [36.7% vs. 16.7%; unadjusted odds ratio (OR), 2.32, 95% confidence interval (CI) 1.12-4.81, p=0.024). Even after adjusting for confounding factors (such as age, gender, smoking history, National Institutes of Health Stroke Scale（NIHSS）on admission, DBP on admission, stenosis rate of carotid artery (CA), calcification, loose matrix, lipo-rich necrotic core (LRNC), and statins accepted at 3 months), IPH was still a strong predictor of poor 3-month outcome, and the adjusted OR was 3.66 (95% CI 1.68-7.94, p=0.001).