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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...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
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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. |
format | Online Article Text |
id | pubmed-5384773 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
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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