Long-Term Prognosis of Patients With Transient Ischemic Attack or Stroke and Symptomatic Vascular Disease in Multiple Arterial Beds

Heldner, Mirjam Rachel; Li, Linxin; Lovett, Nicola; Kubiak, Magdalena; Lyons, Shane; Rothwell, Peter M.

doi:10.1161/strokeaha.118.020913

Cited by 21 publications

(25 citation statements)

References 26 publications

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“…The increased unfavorable outcome rates in patients with previous strokes may be related to their older age 11 and higher frequencies of pre-existing disabilities 12 in general and myocardial disease in particular. 13 Furthermore, patients with previous strokes had lower rates of achieving favorable target vessel recanalization which in itself increases the likelihood of poor outcomes. 14 Most importantly, it appears that at least for a subset of patients with previous strokes, which remains to be better characterized in future studies EVT remains a valuable, life-saving procedure.…”

Section: Discussionmentioning

confidence: 99%

Impact of previous stroke on outcome after thrombectomy in patients with large vessel occlusion

Leker

Cohen

Horev

et al. 2019

International Journal of Stroke

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Background Many patients with large vessel occlusion (LVO) who are otherwise candidates for endovascular treatment (EVT) have had previous strokes. We aimed to examine the effect of previous stroke on outcome after EVT. Methods Consecutive patients with LVO were prospectively entered into a National Acute Stroke registry of patients undergoing EVT. Patients treated with EVT were divided into those with and without previous strokes. The rates of favorable reperfusion status, mortality, and excellent outcome at 90 days post-stroke as well as symptomatic intracranial hemorrhage (sICH) were evaluated. Results A total of 390 underwent EVT and 35 had previous strokes. Patients with previous strokes were significantly older; more frequently had a history of prior myocardial infarction and more often had pre-existing functional disability. Favorable target vessel recanalization was less frequently achieved in patients with previous strokes (60% vs. 82%; p = 0.005) and ordinal regression analysis for functional outcome revealed higher frequency of deterioration at three months in patients with previous strokes. Nevertheless, 9% of these patients maintained their previous disability state and sICH rates did not differ between the groups. Mortality rates at one year post stroke were significantly higher in patients with previous strokes (37% vs. 16%; p = 0.005). Conclusions Previous strokes are associated with higher likelihoods of mortality and unfavorable outcome in patients with LVO undergoing EVT. However, because some of these patients maintain their previous disability state, the presence of previous stroke should not be used as an exclusion criterion from EVT.

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Section: Discussionmentioning

confidence: 99%

Impact of previous stroke on outcome after thrombectomy in patients with large vessel occlusion

Leker

Cohen

Horev

et al. 2019

International Journal of Stroke

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“…В популяционном исследовании OXVASC [16] у пациентов с транзиторной ишемической атакой или ишемическим инсультом (ИИ) наличие ишемической болезни сердца (ИБС) и / или ЗАНК, отмеченное в 27,9 % случаев, также ассоциировалось с увеличением риска развития основных ССО, сосудистой смерти и повторного ИИ при длительном наблюдении. Риск развития ССО при сочетании цереброваскулярной патологии с ЗАНК был более высоким, чем при сочетании с ИБС.…”

Section: распространенность и прогностическое значение мфпаunclassified

Features of Antithrombotic Therapy in Patients with Multifocal Arterial Disease

2021

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Multifocal arterial injury is common in patients with atherosclerotic cardiovascular diseases and is associated with increased risk of cardiovascular complications and death. Administration of more intensive antithrombotic therapy, particularly combinations of acetylsalicylic acid and a “vascular” dose of rivaroxaban, in patients with multifocal arterial injury is characterized by a beneficial ratio of efficiency and safety due to a pronounced decrease in the risk of cardiovascular complications. Detection of peripheral artery diseases in patients with ischemic heart disease and atherosclerotic cerebrovascular pathology makes it possible to improve the risk stratification, optimize the diagnostic tactics and clarify indications for more intensive antithrombotic therapy.

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“…У пациентов с транзиторными ишемическими атаками (ТИА) или ишемическим инсультом в популяционном исследовании OXVASC наличие ишемической болезни сердца (ИБС) и/или заболевания артерий нижних конечностей (ЗАНК) было отмечено в 27,9% случаев [11].…”

Section: Multifocal Arterial Lesion мультифокальное артериальное поражениеunclassified

“…Наличие ИБС и/или ЗАНК у пациентов с ТИА или ишемическим инсультом ассоциировалось с увеличением риска основных ССО, сосудистой смерти и повторного ишемического инсульта при длительном наблюдении [11]. Риск ССО при сочетании цереброваскулярной патологии с ЗАНК был более высоким, чем при ее сочетании с ИБС.…”

Section: прогностическое значением мфапunclassified

Features of Risk Stratification, Diagnosis and Secondary Prevention in Patients with Multifocal Arterial Disease. Part 1: Risk Stratification and Diagnosis

Grachev

Vedenskaya

Smolenskaya

2021

Racionalʹnaâ farmakoterapiâ v kardiologii

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Multifocal arterial disease is common in patients with atherosclerotic cardiovascular disease and is associated with an increased risk of cardiovascular complications and death. The possibility of improving the prognosis of patients with multifocal arterial disease is associated with a more efficient diagnosis of both the underlying disease and obstructive atherosclerotic lesions of other localizations and with a more intensive secondary prevention. According to observational studies, the presence of significant stenoses of the carotid arteries and, especially, lower extremities arterial disease can be predictorы of similar lesions in other vascular beds and their detection with screening methods available in clinical practice allows improvement of the diagnosis in patients with suspected coronary artery disease. On the other hand, screening of lower extremities artery diseases in patients with acute coronary syndrome can clarify indications for the use of invasive diagnostic and treatment strategy, in patients with chronic coronary artery disease it can justify more aggressive approaches to secondary prevention.

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Long-Term Prognosis of Patients With Transient Ischemic Attack or Stroke and Symptomatic Vascular Disease in Multiple Arterial Beds

Abstract: Supplemental Digital Content is available in the text.

Cited by 21 publications

References 26 publications

Impact of previous stroke on outcome after thrombectomy in patients with large vessel occlusion

Impact of previous stroke on outcome after thrombectomy in patients with large vessel occlusion

Features of Antithrombotic Therapy in Patients with Multifocal Arterial Disease

Features of Risk Stratification, Diagnosis and Secondary Prevention in Patients with Multifocal Arterial Disease. Part 1: Risk Stratification and Diagnosis

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