Relevance of stroke subtype in vascular risk prediction

Ois, Ángel; Cuadrado-Godia, Elisa; Rodríguez-Campello, Ana; Giralt-Steinhauer, Eva; Jiménez‐Conde, Jordi; Lopez-Cuiña, Miguel; Ley, Miguel; Soriano, Carol; Roquer, Jaume

doi:10.1212/wnl.0b013e31829e6f37

Cited by 29 publications

(27 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Limited infarction was the most common imaging finding. This finding demonstrates a slightly higher prevalence of carotid atherosclerotic disease as a cause for stroke than those previously postulated 2, 20,27 . A more precise elucidation of the role of vulnerable plaques in non-relevant stenosis and their implications in the absence of concurrent brain infarcts detectable on CT remains uncertain.…”

Section: Discussionmentioning

confidence: 38%

Multidetector computed tomography angiography in clinically suspected hyperacute ischemic stroke in the anterior circulation: an etiological workup in a cohort of Brazilian patients

Pacheco¹,

Littig²,

Gagliardi³

et al. 2015

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

Objective The potential of computed tomography angiography (CTA) was assessed for early determination of stroke subtypes in a Brazilian cohort of patients with stroke. Method From July 2011 to July 2013, we selected patients with suspected hyperacute stroke (< 6 hours). Intracranial and cervical arteries were scrutinized on CTA and their imaging features were correlated with concurrent subtype of stroke. Results Stroke was documented in 50/106 selected patients (47.2%) based on both clinical grounds and imaging follow-up (stroke group), with statistically significant arterial stenosis and vulnerable plaques on CTA. Intracranial large artery disease was demonstrated in 34% of patients in the stroke group. Partial territorial infarct prevailed (86%) while artery-to-artery embolization was the most common stroke mechanism (52%). Conclusion Multidetector CTA was useful for the etiologic work-up of hyperacute ischemic stroke and facilitated the knowledge about the topographic pattern of brain infarct in accordance with its causative mechanism.

show abstract

Section: Discussionmentioning

confidence: 38%

Multidetector computed tomography angiography in clinically suspected hyperacute ischemic stroke in the anterior circulation: an etiological workup in a cohort of Brazilian patients

Pacheco¹,

Littig²,

Gagliardi³

et al. 2015

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

show abstract

“…Previously described diagnostic procedures, care methods, and secondary prevention measures [10] were followed, in accordance with the current stroke guidelines, during the hospital admission.…”

Section: Methodsmentioning

confidence: 99%

Glycated Hemoglobin Value Combined with Initial Glucose Levels for Evaluating Mortality Risk in Patients with Ischemic Stroke

Roquer¹,

Giralt-Steinhauer

Cerdà

et al. 2015

Cerebrovasc Dis

View full text Add to dashboard Cite

Background: Hyperglycemia is a marker of poor outcome in acute ischemic stroke (IS) patients. We aimed at evaluating the effect of combined HbA1c and first glucose measurement values on 3-month mortality prediction. Methods: In a prospective analysis, 1,317 first-ever IS patients with HbA1c values were classified by first glycemia value (<155, 155-199, ≥200 mg/dl). Three-month mortality was analyzed by glycemia category in nondiabetics, diabetics with good previous glucose control (PGC) (HbA1c <7%), and diabetics with poor PGC (HbA1c ≥7.0%). Results: Mortality at 3 months was 13.1%, with no differences (p = 0.339) between non-diabetes mellitus (DM) (12.3%), good PGC-DM (12.4%), and poor PGC-DM (15.6%) patients. The unadjusted relative risk of 3-month mortality for patients with glucose ≥200 mg/dl was 3.76 (95% CI 1.48-9.56) in non-DM, 6.10 (95% CI 1.76-21.09) in good PGC-DM, and 1.44 (95% CI 0.77-2.69) in poor PGC-DM. Glycemia cutoffs most highly correlated with mortality increased as PGC declined: 107 mg/dl in non-DM, 152 mg/dl in good PGC-DM, and 229 mg/dl in poor PGC-DM patients. Glycemia correlated with stroke severity in nondiabetics and diabetic patients with good PGC, but not in those with poor PGC. Conclusions: HbA1c determination combined with first measured glucose value is useful to stratify mortality risk in IS patients: hyperglycemia is a poor prognostic marker in non-DM and DM patients with good PGC; results are inconsistent in poor PGC-DM patients. Our data suggest the relationship between hyperglycemia and poor outcome reflects stress response rather than a deleterious effect of glucose.

show abstract

“…Some studies have found that LAA subtype is associated with a generally increased risk of new vascular events, including both stroke, coronary artery disease and peripheral artery disease. 177,178 Atherosclerosis is a systemic disease and a shared mechanism for coronary artery disease, peripheral artery disease, and atherosclerotic stroke subtype.…”

Section: Vascular Events and Cardiac Diseasementioning

confidence: 99%

Five-year readmission and mortality differ by ischemic stroke subtype

Bjerkreim

Khanevski

Thomassen

et al. 2019

Journal of the Neurological Sciences

View full text Add to dashboard Cite

Background. Stroke aetiology may affect the risk and causes of readmission after ischaemic stroke (IS) and transient ischaemic attack (TIA) due to differences in risk factors, functional outcome, and treatment. We aimed to examine frequencies, causes, and risk of 30-day readmission by stroke subtype, determine predictors of 30-day readmission, and study the impact of 30-day readmissions on one-year mortality. Methods. All surviving patients admitted with IS or TIA from July 2007 to December 2013 were followed by review of medical records for all unplanned readmissions within 30 days after discharge. Stroke subtype was classified as largeartery atherosclerosis (LAA), cardioembolism (CE), small vessel occlusion (SVO), stroke of other determined aetiology (SOE), or stroke of undetermined aetiology (SUE). Cox regression analyses were performed to assess the risk of 30-day readmission for the stroke subtypes and identify predictors of 30-day readmission, and its impact on one-year mortality. Results. Of 1874 patients, 200 (10.7%) were readmitted within 30 days [LAA 42/244 (17.2%), CE 75/605 (12.4%), SVO 12/205 (5.9%), SOE 6/32 (18.8%), SUE 65/788 (8.3%)]. The most frequent causes of readmissions were stroke-related event, infection, recurrent stroke/ TIA, and cardiac disease. After adjusting for age, sex, functional outcome, length of stay, and the risk factor burden, patients with LAA and SOE subtype had significantly higher risks of readmission for any cause, recurrent stroke or TIA, and stroke-related events. Predictors of 30-day readmission were higher age, peripheral arterial disease, enteral feeding, and LAA subtype. Thirty-day readmission was an independent predictor of one-year mortality. Conclusions. Patients with LAA or SOE have a high risk of 30-day readmission, possibly caused by an increased risk of recurrent stroke and stroke-related events. Awareness of the risk of readmission for different causes and appropriate handling according to stroke subtype may be useful for preventing some readmissions after stroke.

show abstract

Relevance of stroke subtype in vascular risk prediction

Abstract: Patients who survive stroke are at increased risk for NVEs. The risk for NVE varies according to stroke subtype.

Cited by 29 publications

References 32 publications

Multidetector computed tomography angiography in clinically suspected hyperacute ischemic stroke in the anterior circulation: an etiological workup in a cohort of Brazilian patients

Multidetector computed tomography angiography in clinically suspected hyperacute ischemic stroke in the anterior circulation: an etiological workup in a cohort of Brazilian patients

Glycated Hemoglobin Value Combined with Initial Glucose Levels for Evaluating Mortality Risk in Patients with Ischemic Stroke

Five-year readmission and mortality differ by ischemic stroke subtype

Contact Info

Product

Resources

About