Cerebral small vessel disease or intracranial large vessel atherosclerosis may carry different risk for future strokes

查看全文 作　　者：Huimin [1,2,3]Chen;Yuesong [1,2,3]Pan;Lixia [1,2,3]Zong;Jing [1,2,3]Jing;Xia [1,2,3]Meng;Yuyuan [1,2,3]Xu;Hongyi [1,2,3]Yan;Xingquan [1,2,3]Zhao;Liping [1,2,3]Liu;Hao [1,2,3]Li;S Claiborne [4]Johnston;Yongjun [1,2,3]Wang;Yilong [1,2,3]Wang

机构地区：[1]Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing,China;[2]China National Clinical Research Center for Neurological Diseases(NCRC-ND),Beijing,China;[3]Advanced Innovation Center for Human Brain Projection,Capital Medical University,Beijing,China;[4]Dell Medical School,University of Texas,Austin,Texas,USA

出　　处：《Stroke & Vascular Neurology》索引2020年第5卷第2期,共10页

基　　金：supported by grants from the Ministry of Science and Technology of the People’s Republic of China(2016YFC0901001,2016YFC0901002,2017YFC1307900,2017YFC1310901,2018YFC1311700 and 2018YFC1311706),Beijing Municipal Committee of Science and Technology(D151100002015003,Beijing Excellent Talents Training and Supporting Top Youth Team,D171100003017001 and 2016000021223TD03),Beijing Municipal Commission of Health and Family Planning(No.2016-1-2041,SML20150502),National Natural Science Foundation of China(81825007),Beijing Municipal Education Commission(Excellent Young Scientists Project)and the third batch of National Ten Thousand Talents Plan,and Beijing Outstanding Young Scientist Program(BJJWZYJH01201910025030). 摘　　要：Background The effect of cerebral small vessel disease(CSVD)and intracranial arterial stenosis(ICAS)on stroke outcomes remains unclear.Methods Data of 1045 patients with minor stroke or transient ischaemic attack(TIA)were obtained from 45 sites of the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events(CHANCE)trial.We assessed the associations of burdens of CSVD and ICAS with new strokes and bleeding events using multivariate Cox regression models and those with modified Rankin Scale(mRS)scores using ordinal logistic regression models.Results Among the 1045 patients,CSVD was present in 830 cases(79.4%)and ICAS in 460(44.0%).Patients with>1 ICAS segment showed the highest risk of new strokes(HR 2.03,95%CI 1.15 to 3.56,p=0.01).No association between CSVD and the occurrence of new strokes was found.The presence of severe CSVD(common OR(cOR)2.01,95%CI 1.40 to 2.89,p<0.001)and>1 ICAS segment(cOR 2.15,95%CI 1.57 to 2.93,p<0.001)was associated with higher mRS scores.Severe CSVD(HR 10.70,95%CI 1.16 to 99.04,p=0.04),but not ICAS,was associated with a higher risk of bleeding events.Six-point modified CSVD score improved the predictive power for bleeding events and disability.Interpretation CSVD is associated with more disability and bleeding events,and ICAS is associated with an increased risk of stroke and disability in patients with minor stroke and TIA at 3 months.CSVD and ICAS may represent different vascular pathologies and play distinct roles in stroke outcomes. 关键词：INTRACRANIAL BLEEDING Acute

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Cerebral small vessel disease or intracranial large vessel atherosclerosis may carry different risk for future strokes

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