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 R...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2017-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5384773?pdf=render |
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| author | Jiann-Shing Jeng Fang-I Hsieh Hsu-Ling Yeh Wei-Hung Chen Hou-Chang Chiu Sung-Chun Tang Chung-Hsiang Liu Huey-Juan Lin Shih-Pin Hsu Yuk-Keung Lo Lung Chan Chih-Hung Chen Ruey-Tay Lin Yu-Wei Chen Jiunn-Tay Lee Chung-Hsin Yeh Ming-Hui Sun Ta-Chang Lai Yu Sun Mu-Chien Sun Po-Lin Chen Tsuey-Ru Chiang Shinn-Kuang Lin Bak-Sau Yip Chin-I Chen Chi-Huey Bai Sien-Tsong Chen Hung-Yi Chiou Li-Ming Lien Chung Y Hsu Taiwan Stroke Registry Investigators |
| author_facet | Jiann-Shing Jeng Fang-I Hsieh Hsu-Ling Yeh Wei-Hung Chen Hou-Chang Chiu Sung-Chun Tang Chung-Hsiang Liu Huey-Juan Lin Shih-Pin Hsu Yuk-Keung Lo Lung Chan Chih-Hung Chen Ruey-Tay Lin Yu-Wei Chen Jiunn-Tay Lee Chung-Hsin Yeh Ming-Hui Sun Ta-Chang Lai Yu Sun Mu-Chien Sun Po-Lin Chen Tsuey-Ru Chiang Shinn-Kuang Lin Bak-Sau Yip Chin-I Chen Chi-Huey Bai Sien-Tsong Chen Hung-Yi Chiou Li-Ming Lien Chung Y Hsu Taiwan Stroke Registry Investigators |
| author_sort | Jiann-Shing Jeng |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-20T03:14:43Z |
| format | Article |
| id | doaj.art-bfe342ab3f3f4a7a9087a9d9f092d566 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-20T03:14:43Z |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-bfe342ab3f3f4a7a9087a9d9f092d5662022-12-21T19:55:23ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01124e017543410.1371/journal.pone.0175434Impact of MCA stenosis on the early outcome in acute ischemic stroke patients.Jiann-Shing JengFang-I HsiehHsu-Ling YehWei-Hung ChenHou-Chang ChiuSung-Chun TangChung-Hsiang LiuHuey-Juan LinShih-Pin HsuYuk-Keung LoLung ChanChih-Hung ChenRuey-Tay LinYu-Wei ChenJiunn-Tay LeeChung-Hsin YehMing-Hui SunTa-Chang LaiYu SunMu-Chien SunPo-Lin ChenTsuey-Ru ChiangShinn-Kuang LinBak-Sau YipChin-I ChenChi-Huey BaiSien-Tsong ChenHung-Yi ChiouLi-Ming LienChung Y HsuTaiwan Stroke Registry InvestigatorsBACKGROUND: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.http://europepmc.org/articles/PMC5384773?pdf=render |
| spellingShingle | Jiann-Shing Jeng Fang-I Hsieh Hsu-Ling Yeh Wei-Hung Chen Hou-Chang Chiu Sung-Chun Tang Chung-Hsiang Liu Huey-Juan Lin Shih-Pin Hsu Yuk-Keung Lo Lung Chan Chih-Hung Chen Ruey-Tay Lin Yu-Wei Chen Jiunn-Tay Lee Chung-Hsin Yeh Ming-Hui Sun Ta-Chang Lai Yu Sun Mu-Chien Sun Po-Lin Chen Tsuey-Ru Chiang Shinn-Kuang Lin Bak-Sau Yip Chin-I Chen Chi-Huey Bai Sien-Tsong Chen Hung-Yi Chiou Li-Ming Lien Chung Y Hsu Taiwan Stroke Registry Investigators Impact of MCA stenosis on the early outcome in acute ischemic stroke patients. PLoS ONE |
| 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 |
| url | http://europepmc.org/articles/PMC5384773?pdf=render |
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