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Long-term outcome of vertebral artery origin stenosis in patients with acute ischemic stroke

BACKGROUND: Vertebral artery origin (VAO) stenosis is occasionally observed in patients who have acute ischemic stroke. We investigated the long-term outcomes and clinical significance of VAO stenosis in patients with acute ischemic stroke. METHODS: We performed a prospective observational study usi...

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Autores principales: Kim, Young Jin, Lee, Joon Hwa, Choi, Jin Woo, Roh, Hong Gee, Chun, Young Il, Lee, Ji-Sung, Kim, Hahn Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833629/
https://www.ncbi.nlm.nih.gov/pubmed/24215371
http://dx.doi.org/10.1186/1471-2377-13-171
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author Kim, Young Jin
Lee, Joon Hwa
Choi, Jin Woo
Roh, Hong Gee
Chun, Young Il
Lee, Ji-Sung
Kim, Hahn Young
author_facet Kim, Young Jin
Lee, Joon Hwa
Choi, Jin Woo
Roh, Hong Gee
Chun, Young Il
Lee, Ji-Sung
Kim, Hahn Young
author_sort Kim, Young Jin
collection PubMed
description BACKGROUND: Vertebral artery origin (VAO) stenosis is occasionally observed in patients who have acute ischemic stroke. We investigated the long-term outcomes and clinical significance of VAO stenosis in patients with acute ischemic stroke. METHODS: We performed a prospective observational study using a single stroke center registry to investigate the risk of recurrent stroke and vascular outcomes in patients with acute ischemic stroke and VAO stenosis. To relate the clinical significance of VAO stenosis to the vascular territory of the index stroke, patients were classified into an asymptomatic VAO stenosis group and a symptomatic VAO stenosis group. RESULTS: Of the 774 patients who had acute ischemic stroke, 149 (19.3%) of them had more than 50% stenosis of the VAO. During 309 patient-years of follow-up (mean, 2.3 years), there were 7 ischemic strokes, 6 hemorrhagic strokes, and 2 unknown strokes. The annual event rates were 0.97% for posterior circulation ischemic stroke, 4.86% for all stroke, and 6.80% for the composite cardiovascular outcome. The annual event rate for ischemic stroke in the posterior circulation was significantly higher in patients who had symptomatic VAO stenosis than in patients who had asymptomatic stenosis (1.88% vs. 0%, p = 0.046). In a multivariate analysis, the hazard ratio, per one point increase of the Essen Stroke Risk Score (ESRS) for the composite cardiovascular outcome, was 1.46 (95% CI, 1.02-2.08, p = 0.036). CONCLUSIONS: Long-term outcomes of more than 50% stenosis of the VAO in patients with acute ischemic stroke were generally favorable. Additionally, ESRS was a predictor for the composite cardiovascular outcome. Asymptomatic VAO stenosis may not be a specific risk factor for recurrent ischemic stroke in the posterior circulation. However, VAO stenosis may require more clinical attention as a potential source of recurrent stroke when VAO stenosis is observed in patients who have concurrent ischemic stroke in the posterior circulation.
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spelling pubmed-38336292013-11-20 Long-term outcome of vertebral artery origin stenosis in patients with acute ischemic stroke Kim, Young Jin Lee, Joon Hwa Choi, Jin Woo Roh, Hong Gee Chun, Young Il Lee, Ji-Sung Kim, Hahn Young BMC Neurol Research Article BACKGROUND: Vertebral artery origin (VAO) stenosis is occasionally observed in patients who have acute ischemic stroke. We investigated the long-term outcomes and clinical significance of VAO stenosis in patients with acute ischemic stroke. METHODS: We performed a prospective observational study using a single stroke center registry to investigate the risk of recurrent stroke and vascular outcomes in patients with acute ischemic stroke and VAO stenosis. To relate the clinical significance of VAO stenosis to the vascular territory of the index stroke, patients were classified into an asymptomatic VAO stenosis group and a symptomatic VAO stenosis group. RESULTS: Of the 774 patients who had acute ischemic stroke, 149 (19.3%) of them had more than 50% stenosis of the VAO. During 309 patient-years of follow-up (mean, 2.3 years), there were 7 ischemic strokes, 6 hemorrhagic strokes, and 2 unknown strokes. The annual event rates were 0.97% for posterior circulation ischemic stroke, 4.86% for all stroke, and 6.80% for the composite cardiovascular outcome. The annual event rate for ischemic stroke in the posterior circulation was significantly higher in patients who had symptomatic VAO stenosis than in patients who had asymptomatic stenosis (1.88% vs. 0%, p = 0.046). In a multivariate analysis, the hazard ratio, per one point increase of the Essen Stroke Risk Score (ESRS) for the composite cardiovascular outcome, was 1.46 (95% CI, 1.02-2.08, p = 0.036). CONCLUSIONS: Long-term outcomes of more than 50% stenosis of the VAO in patients with acute ischemic stroke were generally favorable. Additionally, ESRS was a predictor for the composite cardiovascular outcome. Asymptomatic VAO stenosis may not be a specific risk factor for recurrent ischemic stroke in the posterior circulation. However, VAO stenosis may require more clinical attention as a potential source of recurrent stroke when VAO stenosis is observed in patients who have concurrent ischemic stroke in the posterior circulation. BioMed Central 2013-11-11 /pmc/articles/PMC3833629/ /pubmed/24215371 http://dx.doi.org/10.1186/1471-2377-13-171 Text en Copyright © 2013 Kim et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Kim, Young Jin
Lee, Joon Hwa
Choi, Jin Woo
Roh, Hong Gee
Chun, Young Il
Lee, Ji-Sung
Kim, Hahn Young
Long-term outcome of vertebral artery origin stenosis in patients with acute ischemic stroke
title Long-term outcome of vertebral artery origin stenosis in patients with acute ischemic stroke
title_full Long-term outcome of vertebral artery origin stenosis in patients with acute ischemic stroke
title_fullStr Long-term outcome of vertebral artery origin stenosis in patients with acute ischemic stroke
title_full_unstemmed Long-term outcome of vertebral artery origin stenosis in patients with acute ischemic stroke
title_short Long-term outcome of vertebral artery origin stenosis in patients with acute ischemic stroke
title_sort long-term outcome of vertebral artery origin stenosis in patients with acute ischemic stroke
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833629/
https://www.ncbi.nlm.nih.gov/pubmed/24215371
http://dx.doi.org/10.1186/1471-2377-13-171
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