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Impact of MCA stenosis on the early outcome in acute ischemic stroke patients

BACKGROUND: Asians have higher frequency of intracranial arterial stenosis. The present study aimed to compare the clinical features and outcomes of ischemic stroke patients with and without middle cerebral artery (MCA) stenosis, assessed by transcranial sonography (TCS), based on the Taiwan Stroke...

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Autores principales: Jeng, Jiann-Shing, Hsieh, Fang-I, Yeh, Hsu-Ling, Chen, Wei-Hung, Chiu, Hou-Chang, Tang, Sung-Chun, Liu, Chung-Hsiang, Lin, Huey-Juan, Hsu, Shih-Pin, Lo, Yuk-Keung, Chan, Lung, Chen, Chih-Hung, Lin, Ruey-Tay, Chen, Yu-Wei, Lee, Jiunn-Tay, Yeh, Chung-Hsin, Sun, Ming-Hui, Lai, Ta-Chang, Sun, Yu, Sun, Mu-Chien, Chen, Po-Lin, Chiang, Tsuey-Ru, Lin, Shinn-Kuang, Yip, Bak-Sau, Chen, Chin-I, Bai, Chi-Huey, Chen, Sien-Tsong, Chiou, Hung-Yi, Lien, Li-Ming, Hsu, Chung Y.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5384773/
https://www.ncbi.nlm.nih.gov/pubmed/28388675
http://dx.doi.org/10.1371/journal.pone.0175434
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author Jeng, Jiann-Shing
Hsieh, Fang-I
Yeh, Hsu-Ling
Chen, Wei-Hung
Chiu, Hou-Chang
Tang, Sung-Chun
Liu, Chung-Hsiang
Lin, Huey-Juan
Hsu, Shih-Pin
Lo, Yuk-Keung
Chan, Lung
Chen, Chih-Hung
Lin, Ruey-Tay
Chen, Yu-Wei
Lee, Jiunn-Tay
Yeh, Chung-Hsin
Sun, Ming-Hui
Lai, Ta-Chang
Sun, Yu
Sun, Mu-Chien
Chen, Po-Lin
Chiang, Tsuey-Ru
Lin, Shinn-Kuang
Yip, Bak-Sau
Chen, Chin-I
Bai, Chi-Huey
Chen, Sien-Tsong
Chiou, Hung-Yi
Lien, Li-Ming
Hsu, Chung Y.
author_facet Jeng, Jiann-Shing
Hsieh, Fang-I
Yeh, Hsu-Ling
Chen, Wei-Hung
Chiu, Hou-Chang
Tang, Sung-Chun
Liu, Chung-Hsiang
Lin, Huey-Juan
Hsu, Shih-Pin
Lo, Yuk-Keung
Chan, Lung
Chen, Chih-Hung
Lin, Ruey-Tay
Chen, Yu-Wei
Lee, Jiunn-Tay
Yeh, Chung-Hsin
Sun, Ming-Hui
Lai, Ta-Chang
Sun, Yu
Sun, Mu-Chien
Chen, Po-Lin
Chiang, Tsuey-Ru
Lin, Shinn-Kuang
Yip, Bak-Sau
Chen, Chin-I
Bai, Chi-Huey
Chen, Sien-Tsong
Chiou, Hung-Yi
Lien, Li-Ming
Hsu, Chung Y.
author_sort Jeng, Jiann-Shing
collection PubMed
description BACKGROUND: Asians have higher frequency of intracranial arterial stenosis. The present study aimed to compare the clinical features and outcomes of ischemic stroke patients with and without middle cerebral artery (MCA) stenosis, assessed by transcranial sonography (TCS), based on the Taiwan Stroke Registry (TSR). METHODS: Patients with acute ischemic stroke or transient ischemic attack registered in the TSR, and received both carotid duplex and TCS assessment were categorized into those with stenosis (≥50%) and without (<50%) in the extracranial internal carotid artery (ICA) and MCA, respectively. Logistic regression analysis, Kaplan-Meier method and Cox proportional hazard model were applied to assess relevant variables between groups. RESULTS: Of 6003 patients, 23.3% had MCA stenosis, 10.1% ICA stenosis, and 3.9% both MCA and ICA stenosis. Patients with MCA stenosis had greater initial NIHSS, higher likelihood of stroke-in-evolution, and more severe disability than those without (all p<0.001). Patients with MCA stenosis had higher prevalence of hypertension, diabetes and hypercholesterolemia. Patients with combined MCA and extracranial ICA stenosis had even higher NIHSS, worse functional outcome, higher risk of stroke recurrence or death (hazard ratio, 2.204; 95% confidence intervals, 1.440–3.374; p<0.001) at 3 months after stroke than those without MCA stenosis. CONCLUSIONS: In conclusion, MCA stenosis was more prevalent than extracranial ICA stenosis in ischemic stroke patients in Taiwan. Patients with MCA stenosis, especially combined extracranial ICA stenosis, had more severe neurological deficit and worse outcome.
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spelling pubmed-53847732017-05-03 Impact of MCA stenosis on the early outcome in acute ischemic stroke patients Jeng, Jiann-Shing Hsieh, Fang-I Yeh, Hsu-Ling Chen, Wei-Hung Chiu, Hou-Chang Tang, Sung-Chun Liu, Chung-Hsiang Lin, Huey-Juan Hsu, Shih-Pin Lo, Yuk-Keung Chan, Lung Chen, Chih-Hung Lin, Ruey-Tay Chen, Yu-Wei Lee, Jiunn-Tay Yeh, Chung-Hsin Sun, Ming-Hui Lai, Ta-Chang Sun, Yu Sun, Mu-Chien Chen, Po-Lin Chiang, Tsuey-Ru Lin, Shinn-Kuang Yip, Bak-Sau Chen, Chin-I Bai, Chi-Huey Chen, Sien-Tsong Chiou, Hung-Yi Lien, Li-Ming Hsu, Chung Y. PLoS One Research Article BACKGROUND: Asians have higher frequency of intracranial arterial stenosis. The present study aimed to compare the clinical features and outcomes of ischemic stroke patients with and without middle cerebral artery (MCA) stenosis, assessed by transcranial sonography (TCS), based on the Taiwan Stroke Registry (TSR). METHODS: Patients with acute ischemic stroke or transient ischemic attack registered in the TSR, and received both carotid duplex and TCS assessment were categorized into those with stenosis (≥50%) and without (<50%) in the extracranial internal carotid artery (ICA) and MCA, respectively. Logistic regression analysis, Kaplan-Meier method and Cox proportional hazard model were applied to assess relevant variables between groups. RESULTS: Of 6003 patients, 23.3% had MCA stenosis, 10.1% ICA stenosis, and 3.9% both MCA and ICA stenosis. Patients with MCA stenosis had greater initial NIHSS, higher likelihood of stroke-in-evolution, and more severe disability than those without (all p<0.001). Patients with MCA stenosis had higher prevalence of hypertension, diabetes and hypercholesterolemia. Patients with combined MCA and extracranial ICA stenosis had even higher NIHSS, worse functional outcome, higher risk of stroke recurrence or death (hazard ratio, 2.204; 95% confidence intervals, 1.440–3.374; p<0.001) at 3 months after stroke than those without MCA stenosis. CONCLUSIONS: In conclusion, MCA stenosis was more prevalent than extracranial ICA stenosis in ischemic stroke patients in Taiwan. Patients with MCA stenosis, especially combined extracranial ICA stenosis, had more severe neurological deficit and worse outcome. Public Library of Science 2017-04-07 /pmc/articles/PMC5384773/ /pubmed/28388675 http://dx.doi.org/10.1371/journal.pone.0175434 Text en © 2017 Jeng et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Jeng, Jiann-Shing
Hsieh, Fang-I
Yeh, Hsu-Ling
Chen, Wei-Hung
Chiu, Hou-Chang
Tang, Sung-Chun
Liu, Chung-Hsiang
Lin, Huey-Juan
Hsu, Shih-Pin
Lo, Yuk-Keung
Chan, Lung
Chen, Chih-Hung
Lin, Ruey-Tay
Chen, Yu-Wei
Lee, Jiunn-Tay
Yeh, Chung-Hsin
Sun, Ming-Hui
Lai, Ta-Chang
Sun, Yu
Sun, Mu-Chien
Chen, Po-Lin
Chiang, Tsuey-Ru
Lin, Shinn-Kuang
Yip, Bak-Sau
Chen, Chin-I
Bai, Chi-Huey
Chen, Sien-Tsong
Chiou, Hung-Yi
Lien, Li-Ming
Hsu, Chung Y.
Impact of MCA stenosis on the early outcome in acute ischemic stroke patients
title Impact of MCA stenosis on the early outcome in acute ischemic stroke patients
title_full Impact of MCA stenosis on the early outcome in acute ischemic stroke patients
title_fullStr Impact of MCA stenosis on the early outcome in acute ischemic stroke patients
title_full_unstemmed Impact of MCA stenosis on the early outcome in acute ischemic stroke patients
title_short Impact of MCA stenosis on the early outcome in acute ischemic stroke patients
title_sort impact of mca stenosis on the early outcome in acute ischemic stroke patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5384773/
https://www.ncbi.nlm.nih.gov/pubmed/28388675
http://dx.doi.org/10.1371/journal.pone.0175434
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