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Use of magnetic resonance angiography to predict long-term outcomes of ischemic stroke patients with concurrent stenoses in Hong Kong.
Cerebrovasc Dis. 2009; 28(2):112-8.CD

Abstract

PURPOSE

To determine the long-term outcome of ischemic stroke patients with concurrent intracranial and extracranial atherosclerosis using magnetic resonance angiography.

METHODS

A prospective cohort of patients in Hong Kong with acute ischemic stroke was studied with magnetic resonance angiography of the brain and carotid duplex. All patients were followed up regularly for the development of recurrent stroke, cardiac events, or death.

RESULTS

Totally 343 patients with acute ischemic stroke were included, of whom 104 (30%) had concurrent intracranial and extracranial lesions. The follow-up period was up to 76 months (mean 44.5 months). Overall, 55 patients (15.5%) died of any cause and 91 patients (26.5%) suffered a further nonfatal vascular event. The overall 5-year cumulative rates of mortality, restroke and poor outcomes (combined death and further vascular events) were 18, 27 and 37%, respectively. In patients with concurrent lesions, these rates were 31, 41 and 51%, respectively. The corresponding rates were 13, 22 and 31% in patients without concurrent lesions. The risks were highest in the first year after stroke. More deaths (log rank, 16.3; p = 0.0001), restrokes (log rank, 9.71; p = 0.002) and poor outcomes (log rank, 13.87; p = 0.0001) were found among patients with concurrent lesions. The presence of concurrent vascular lesions, advanced age, smoking, hyperlipidemia and previous history of stroke were independent predictors of poor outcomes.

CONCLUSIONS

The long-term prognosis of ischemic stroke patients with concurrent atherosclerosis of intracranial and extracranial vessels is poor. They are at high risk of further vascular events or death.

Authors+Show Affiliations

Division of Neurology, Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong, SAR, China. manbikling@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19506369

Citation

Man, B L., et al. "Use of Magnetic Resonance Angiography to Predict Long-term Outcomes of Ischemic Stroke Patients With Concurrent Stenoses in Hong Kong." Cerebrovascular Diseases (Basel, Switzerland), vol. 28, no. 2, 2009, pp. 112-8.
Man BL, Fu YP, Chan YY, et al. Use of magnetic resonance angiography to predict long-term outcomes of ischemic stroke patients with concurrent stenoses in Hong Kong. Cerebrovasc Dis. 2009;28(2):112-8.
Man, B. L., Fu, Y. P., Chan, Y. Y., Lam, W., Hui, C. F., Leung, W. H., & Wong, K. S. (2009). Use of magnetic resonance angiography to predict long-term outcomes of ischemic stroke patients with concurrent stenoses in Hong Kong. Cerebrovascular Diseases (Basel, Switzerland), 28(2), 112-8. https://doi.org/10.1159/000223435
Man BL, et al. Use of Magnetic Resonance Angiography to Predict Long-term Outcomes of Ischemic Stroke Patients With Concurrent Stenoses in Hong Kong. Cerebrovasc Dis. 2009;28(2):112-8. PubMed PMID: 19506369.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of magnetic resonance angiography to predict long-term outcomes of ischemic stroke patients with concurrent stenoses in Hong Kong. AU - Man,B L, AU - Fu,Y P, AU - Chan,Y Y, AU - Lam,W, AU - Hui,C F, AU - Leung,W H, AU - Wong,K S, Y1 - 2009/06/05/ PY - 2008/10/02/received PY - 2009/03/16/accepted PY - 2009/6/10/entrez PY - 2009/6/10/pubmed PY - 2009/9/25/medline SP - 112 EP - 8 JF - Cerebrovascular diseases (Basel, Switzerland) JO - Cerebrovasc Dis VL - 28 IS - 2 N2 - PURPOSE: To determine the long-term outcome of ischemic stroke patients with concurrent intracranial and extracranial atherosclerosis using magnetic resonance angiography. METHODS: A prospective cohort of patients in Hong Kong with acute ischemic stroke was studied with magnetic resonance angiography of the brain and carotid duplex. All patients were followed up regularly for the development of recurrent stroke, cardiac events, or death. RESULTS: Totally 343 patients with acute ischemic stroke were included, of whom 104 (30%) had concurrent intracranial and extracranial lesions. The follow-up period was up to 76 months (mean 44.5 months). Overall, 55 patients (15.5%) died of any cause and 91 patients (26.5%) suffered a further nonfatal vascular event. The overall 5-year cumulative rates of mortality, restroke and poor outcomes (combined death and further vascular events) were 18, 27 and 37%, respectively. In patients with concurrent lesions, these rates were 31, 41 and 51%, respectively. The corresponding rates were 13, 22 and 31% in patients without concurrent lesions. The risks were highest in the first year after stroke. More deaths (log rank, 16.3; p = 0.0001), restrokes (log rank, 9.71; p = 0.002) and poor outcomes (log rank, 13.87; p = 0.0001) were found among patients with concurrent lesions. The presence of concurrent vascular lesions, advanced age, smoking, hyperlipidemia and previous history of stroke were independent predictors of poor outcomes. CONCLUSIONS: The long-term prognosis of ischemic stroke patients with concurrent atherosclerosis of intracranial and extracranial vessels is poor. They are at high risk of further vascular events or death. SN - 1421-9786 UR - https://www.unboundmedicine.com/medline/citation/19506369/Use_of_magnetic_resonance_angiography_to_predict_long_term_outcomes_of_ischemic_stroke_patients_with_concurrent_stenoses_in_Hong_Kong_ L2 - https://www.karger.com?DOI=10.1159/000223435 DB - PRIME DP - Unbound Medicine ER -