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Cerebral small vessel disease or intracranial large vessel atherosclerosis may carry different risk for future strokes.
| Content Provider | Europe PMC |
|---|---|
| Author | Chen, Huimin Pan, Yuesong Zong, Lixia Jing, Jing Meng, Xia Xu, Yuyuan Yan, Hongyi Zhao, Xingquan Liu, Liping Li, Hao Johnston, S Claiborne Wang, Yongjun Wang, Yilong |
| Copyright Year | 2020 |
| Abstract | BackgroundThe effect of cerebral small vessel disease (CSVD) and intracranial arterial stenosis (ICAS) on stroke outcomes remains unclear.MethodsData of 1045 patients with minor stroke or transient ischaemic attack (TIA) were obtained from 45 sites of the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. We assessed the associations of burdens of CSVD and ICAS with new strokes and bleeding events using multivariate Cox regression models and those with modified Rankin Scale (mRS) scores using ordinal logistic regression models.ResultsAmong the 1045 patients, CSVD was present in 830 cases (79.4%) and ICAS in 460 (44.0%). Patients with >1 ICAS segment showed the highest risk of new strokes (HR 2.03, 95% CI 1.15 to 3.56, p=0.01). No association between CSVD and the occurrence of new strokes was found. The presence of severe CSVD (common OR (cOR) 2.01, 95% CI 1.40 to 2.89, p<0.001) and >1 ICAS segment (cOR 2.15, 95% CI 1.57 to 2.93, p<0.001) was associated with higher mRS scores. Severe CSVD (HR 10.70, 95% CI 1.16 to 99.04, p=0.04), but not ICAS, was associated with a higher risk of bleeding events. Six-point modified CSVD score improved the predictive power for bleeding events and disability.InterpretationCSVD is associated with more disability and bleeding events, and ICAS is associated with an increased risk of stroke and disability in patients with minor stroke and TIA at 3 months. CSVD and ICAS may represent different vascular pathologies and play distinct roles in stroke outcomes.Trial registration numberNCT00979589 |
| Related Links | https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC7337361&blobtype=pdf |
| ISSN | 20598688 |
| Journal | Stroke and Vascular Neurology [Stroke Vasc Neurol] |
| Volume Number | 5 |
| DOI | 10.1136/svn-2019-000305 |
| PubMed Central reference number | PMC7337361 |
| Issue Number | 2 |
| PubMed reference number | 32606085 |
| e-ISSN | 20598696 |
| Language | English |
| Publisher | BMJ Publishing Group |
| Publisher Date | 2020-04-15 |
| Publisher Place | BMA House, Tavistock Square, London, WC1H 9JR |
| Access Restriction | Open |
| Rights License | This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. |
| Subject Keyword | cerebral small vessel disease intracranial arterial stenosis stroke |
| Content Type | Text |
| Resource Type | Article |
| Subject | Neurology (clinical) Cardiology and Cardiovascular Medicine |
