Stroke severity, early recovery and outcome are each related with clinical classification of stroke: Data from the ‘Tinzaparin in Acute Ischaemic Stroke Trial’ (TAIST)

Sprigg, Nikola; Gray, Laura J.; Bath, Philip M.W.; Lindenstrøm, E; Boysen, Gudrun; Deyn, Peter Paul De; Friis, Pål; Leys, Didier; Marttila, Reijo J.; Olsson, Jan-Edwin; O’Neill, Desmond; Ringelstein, E. B.; Sande, Jan-Jacob van der; Turpie, Alexander G.G.

doi:10.1016/j.jns.2006.12.016

Cited by 28 publications

(18 citation statements)

References 24 publications

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“…The presence of TACI and the National Institutes of Health Stroke Scale (NIHSS) scores were independent predictors of poor outcome. These findings were the same as those in middle-aged and old stroke [19,20]. The 40 cases of young IS studied by Khan et al, included 40% TACI, 12.5% PACI, 42.5% LACI and 5% POCI, in which there were more cases of major stroke (TACI) [22].…”

Section: Subtype Constituents Of Issupporting

confidence: 77%

“…The OCSP classification can predict the severity and prognosis of stroke [19,20], but it has seldom been applied to young stroke research. Nedeltchev et al, [21] prospectively studied 203 cases of young IS (in 16-to 45-year-olds), in which the number of OCSP subtypes was PACI >POCI >LACI >TACI and the severity of nervous impairment was TACI > PACI > POCI > LACI.…”

Section: Subtype Constituents Of Ismentioning

confidence: 99%

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Classification analysis of young stroke in zhuhai city, China

Li¹,

Wang²,

Luo³

et al. 2013

Neurosci Discov

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Background: The morbidity and mortality rates in young Chinese stroke patients have increased, and the appropriate classification of stroke is very important to identifying the cause, pathogenesis, severity, outcome, and preventive and therapeutic strategies. This study sought to analyse the young stroke subtype in a coastal city Zhuhai of southern China. Methods: Hospitalised young stroke patients in the two largest local hospitals were retrospectively analysed from July 2002 to July 2009. The percentage of every stroke subtype was calculated. Results: A total of 416 young stroke patients (age 18-45 years) were included. There were 225 (54.1%) cases of ischemic stroke (IS), 145 (34.9%) cases of intracerebral haemorrhage (ICH), 38 (9.1%) cases of subarachnoid haemorrhage (SAH), and 8 (1.9%) cases of mixed stroke (MS). Cases of IS were divided into four groups using the OCSP criteria: 15 (6.7%) total anterior circulation infarcts (TACI), 117 (52.0%) partial anterior circulation infarcts (PACI), 61 (27.1%) lacunar infarcts (LACI ), and 32 (14.2%) posterior circulation infarcts (POCI). Cases of IS were divided into five groups using the TOAST criteria: 14 (6.2%) cases of large-artery atherosclerosis (LAA), 15 (6.7%) cases of cardioembolism (CE), 108 (48 %) cases of small-artery occlusion (SAO), 16 (7.1%) cases of stroke of other determined aetiologies (SOE), and 72 (32%) cases of stroke of undetermined aetiology (SUE). Conclusions:The results suggested that within the locality, the majority of cases of young stroke were IS and ICH, and the minority were SAH and MS; additionally, the most common IS subtypes were PACI, LACI or SAO and SUE, which could contribute to the local prevention and control of stroke.

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Section: Subtype Constituents Of Issupporting

confidence: 77%

Section: Subtype Constituents Of Ismentioning

confidence: 99%

Classification analysis of young stroke in zhuhai city, China

Li¹,

Wang²,

Luo³

et al. 2013

Neurosci Discov

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“…A previous study has indicated that the type of stroke influences functional outcomes, with lacunar infarcts being associated with the greatest recovery and most favorable outcomes, and total anterior circulation infarcts being associated with the poorest recovery and worst outcomes. 26 …”

Section: Table 4 Incidence Of Bleeding and Intracerebral Hemorrhage mentioning

confidence: 99%

“…В ранее проведенном исследовании было показано, что вариант инсульта влияет на функциональный исход. Так, например, лакунарные инфаркты ассо-циированы с лучшим восстановлением и благопри-ятными исходами, а обширные инфаркты в бассейне передней мозговой артерии ассоциированы с самым медленным восстановлением и наиболее неблаго-приятными исходами [26]. nРЕзЮМЕ Таким образом, при дополнительном анализе данных исследования PREVAIL было показано, что профилакти-ка ВТЭ с использованием эноксапарина по сравнению с НФГ у пациентов с острым ИИ не сопровождается ухудшением отдаленных неврологических исходов или повышением риска развития симптомных или фаталь-ных внутричерепных кровоизлияний.…”

Section: Nобсуждениеunclassified

Neurological Outcomes in Patients With Ischemic Stroke Receiving Enoxaparin or Heparin for Venous Thromboembolism Prophylaxis

Kase

Albers

Bladin

et al. 2009

Stroke

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on behalf of the PREVAIL InvestigatorsBackground and Purpose-The Prevention of VTE after Acute Ischemic Stroke with LMWH (PREVAIL) study demonstrated that enoxaparin was superior to unfractionated heparin (UFH) in preventing venous thromboembolism in patients with ischemic stroke and was associated with a small but statistically significant increase in extracranial hemorrhage rates. In this PREVAIL subanalysis, we evaluate the long-term neurological outcomes associated with the use of enoxaparin compared with UFH. We also determine predictors of stroke progression. Methods-Acute ischemic stroke patients aged Ն18 years, who could not walk unassisted, were randomized to receive enoxaparin (40 mg once daily) or UFH (5000 U every 12 hours) for 10 days. Patients were stratified according to baseline stroke severity using the National Institutes of Health Stroke Scale score. End points for this analysis included stroke progression (Ն4-point increase in National Institutes of Health Stroke Scale score), neurological outcomes up to 3 months postrandomization (assessed using National Institutes of Health Stroke Scale score and modified Rankin Scale score), and incidence of intracranial hemorrhage. Results-Stroke progression occurred in 45 of 877 (5.1%) patients in the enoxaparin group and 42 of 872 (4.8%) of those receiving UFH. Similar improvements in National Institutes of Health Stroke Scale and modified Rankin Scale scores were observed in both groups over the 90-day follow-up period. Incidence of intracranial hemorrhage was comparable between groups (20 of 877 [2.3%] and 22 of 872 [2.5%] in enoxaparin and UFH groups, respectively). Baseline National Institutes of Health Stroke Scale score, hyperlipidemia, and Hispanic ethnicity were independent predictors of stroke progression. Conclusions-The clinical benefits associated with use of enoxaparin for venous thromboembolism prophylaxis in patients with acute ischemic stroke are not associated with poorer long-term neurological outcomes or increased rates of symptomatic intracranial hemorrhage compared with UFH. Key Words: intracerebral hemorrhage Ⅲ ischemic stroke Ⅲ venous thromboembolism V enous thromboembolism (VTE) is a clinically important complication after a stroke. Without VTE prophylaxis, up to 75% of patients with stroke are likely to develop deep vein thrombosis 1,2 ; pulmonary embolism accounts for up to 25% of early deaths after a stroke. 3 Therefore, VTE prophylaxis is recommended in consensus guidelines for the management of patients with acute ischemic stroke. 4 -6 Anticoagulation with unfractionated heparin (UFH) or a low-molecular-weight heparin (LMWH) is commonly prescribed to stroke patients to reduce the risk of VTE. In the International Stroke Trial (IST), UFH was shown to significantly reduce the incidence of pulmonary embolism and stroke recurrence in patients with acute ischemic stroke. Several studies have demonstrated that anticoagulation therapy with LMWHs or UFH does not adversely affect functional or neurological outcomes in patients wit...

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“…The Oxfordshire Community Stroke Project Classification (OCSP), which provides prognostic information about stroke outcomes in the short and long term periods [8][9][10] , is based on epidemiological observational studies and no pathophysiological measurements were undertaken in its development. Saji et al report that arterial stiffness measured by PWV is independently associated with progressive neurological deficit after acute stroke 11 .…”

Section: Introductionmentioning

confidence: 99%

The Association between Arterial Stiffness, Initial Stroke Severity, and 3-Week Outcomes in Patients with Ischemic Stroke

Ormerod

Ali

Cameron

et al. 2017

Journal of Stroke and Cerebrovascular Diseases

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Objectives: Vascular compliance is emerging as a useful cardiovascular risk factor.The aim of this study was to investigate the association between arterial stiffness and stroke severity at presentation and at three weeks. Methods:From an initial sample of 73 patients, 42 were included (55% male, mean age 71 years) with acute ischaemic stroke, over a 15 month period. Stroke subtypes were classified into LACI, PACI and POCI. Arterial stiffness was measured by QKD using 24-hour ambulatory blood pressure and ECG monitoring. The measured QKD values were then corrected for a heart rate of 60bpm and a systolic blood pressure (SBP) of 100 mmHg (QKD 100-60 ). Stroke severity was assessed on admission and after 3 weeks, using the National Institute of Health Stroke Scale (NIHSS). Results:There was a non-significant weak correlation between initial stroke severity and QKD 100-60 (r= -0.3, p = 0.08). This correlation was weaker at 3 weeks (r= 0.125, p=0.47). There was no difference in NIHSS at week 0 and 3, or QKD 100-60, between the different stroke types (LACI, PACI and POCI) or dipper versus non-dippers and reverse dippers. Conclusions:This study highlights the need for further research into the association between QKD and initial stroke severity.

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Stroke severity, early recovery and outcome are each related with clinical classification of stroke: Data from the ‘Tinzaparin in Acute Ischaemic Stroke Trial’ (TAIST)

Cited by 28 publications

References 24 publications

Classification analysis of young stroke in zhuhai city, China

Classification analysis of young stroke in zhuhai city, China

Neurological Outcomes in Patients With Ischemic Stroke Receiving Enoxaparin or Heparin for Venous Thromboembolism Prophylaxis

The Association between Arterial Stiffness, Initial Stroke Severity, and 3-Week Outcomes in Patients with Ischemic Stroke

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