Impact of MCA stenosis on the early outcome in acute ischemic stroke patients

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 SunPo 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

研究成果: 雜誌貢獻文章

3 引文 (Scopus)

摘要

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 hypercholesterol-emia. 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.
原文英語
文章編號e0175434
期刊PLoS One
12
發行號4
DOIs
出版狀態已發佈 - 四月 1 2017

指紋

Ultrasonography
Middle Cerebral Artery
stroke
arteries
Hazards
Pathologic Constriction
Stroke
carotid arteries
Carotid Stenosis
Medical problems
Regression analysis
Logistics
Taiwan
ultrasonography
Registries
Transient Ischemic Attack
Internal Carotid Artery
Proportional Hazards Models
hypertension
diabetes

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

引用此文

Jeng, J. S., Hsieh, F. I., Yeh, H. L., Chen, W. H., Chiu, H. C., Tang, S. C., ... Hsu, C. Y. (2017). Impact of MCA stenosis on the early outcome in acute ischemic stroke patients. PLoS One, 12(4), [e0175434]. https://doi.org/10.1371/journal.pone.0175434

Impact of MCA stenosis on the early outcome in acute ischemic stroke patients. / Jeng, Jiann Shing; Hsieh, Fang I.; Yeh, Hsu Ling; Chen, Wei Hung; Chiu, Hou Chang; Tang, Sung Chun; Liu, Chung Hsiang; Lin, Huey Juan; Hsu, Shih Pin; Lo, Yuk Keung; Chan, Lung; Chen, Chih Hung; Lin, Ruey Tay; Chen, Yu Wei; Lee, Jiunn Tay; Yeh, Chung Hsin; Sun, Ming Hui; Lai, Ta Chang; Sun, Yu; Sun, Mu Chien; Chen, Po Lin; Chiang, Tsuey Ru; Lin, Shinn Kuang; Yip, Bak Sau; Chen, Chin I.; Bai, Chi Huey; Chen, Sien Tsong; Chiou, Hung Yi; Lien, Li Ming; Hsu, Chung Y.

於: PLoS One, 卷 12, 編號 4, e0175434, 01.04.2017.

研究成果: 雜誌貢獻文章

Jeng, JS, Hsieh, FI, Yeh, HL, Chen, WH, Chiu, HC, Tang, SC, Liu, CH, Lin, HJ, Hsu, SP, Lo, YK, Chan, L, Chen, CH, Lin, RT, Chen, YW, Lee, JT, Yeh, CH, Sun, MH, Lai, TC, Sun, Y, Sun, MC, Chen, PL, Chiang, TR, Lin, SK, Yip, BS, Chen, CI, Bai, CH, Chen, ST, Chiou, HY, Lien, LM & Hsu, CY 2017, 'Impact of MCA stenosis on the early outcome in acute ischemic stroke patients', PLoS One, 卷 12, 編號 4, e0175434. https://doi.org/10.1371/journal.pone.0175434
Jeng, Jiann Shing ; Hsieh, Fang I. ; Yeh, Hsu Ling ; Chen, Wei Hung ; Chiu, Hou Chang ; Tang, Sung Chun ; Liu, Chung Hsiang ; Lin, Huey Juan ; Hsu, Shih Pin ; Lo, Yuk Keung ; Chan, Lung ; Chen, Chih Hung ; Lin, Ruey Tay ; Chen, Yu Wei ; Lee, Jiunn Tay ; Yeh, Chung Hsin ; Sun, Ming Hui ; Lai, Ta Chang ; Sun, Yu ; Sun, Mu Chien ; Chen, Po Lin ; Chiang, Tsuey Ru ; Lin, Shinn Kuang ; Yip, Bak Sau ; Chen, Chin I. ; Bai, Chi Huey ; Chen, Sien Tsong ; Chiou, Hung Yi ; Lien, Li Ming ; Hsu, Chung Y. / Impact of MCA stenosis on the early outcome in acute ischemic stroke patients. 於: PLoS One. 2017 ; 卷 12, 編號 4.
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title = "Impact of MCA stenosis on the early outcome in acute ischemic stroke patients",
abstract = "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 hypercholesterol-emia. 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.",
author = "Jeng, {Jiann Shing} and Hsieh, {Fang I.} and Yeh, {Hsu Ling} and Chen, {Wei Hung} and Chiu, {Hou Chang} and Tang, {Sung Chun} and Liu, {Chung Hsiang} and Lin, {Huey Juan} and Hsu, {Shih Pin} and Lo, {Yuk Keung} and Lung Chan and Chen, {Chih Hung} and Lin, {Ruey Tay} and Chen, {Yu Wei} and Lee, {Jiunn Tay} and Yeh, {Chung Hsin} and Sun, {Ming Hui} and Lai, {Ta Chang} and Yu Sun and Sun, {Mu Chien} and Chen, {Po Lin} and Chiang, {Tsuey Ru} and Lin, {Shinn Kuang} and Yip, {Bak Sau} and Chen, {Chin I.} and Bai, {Chi Huey} and Chen, {Sien Tsong} and Chiou, {Hung Yi} and Lien, {Li Ming} and Hsu, {Chung Y.}",
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T1 - Impact of MCA stenosis on the early outcome in acute ischemic stroke patients

AU - Jeng, Jiann Shing

AU - Hsieh, Fang I.

AU - Yeh, Hsu Ling

AU - Chen, Wei Hung

AU - Chiu, Hou Chang

AU - Tang, Sung Chun

AU - Liu, Chung Hsiang

AU - Lin, Huey Juan

AU - Hsu, Shih Pin

AU - Lo, Yuk Keung

AU - Chan, Lung

AU - Chen, Chih Hung

AU - Lin, Ruey Tay

AU - Chen, Yu Wei

AU - Lee, Jiunn Tay

AU - Yeh, Chung Hsin

AU - Sun, Ming Hui

AU - Lai, Ta Chang

AU - Sun, Yu

AU - Sun, Mu Chien

AU - Chen, Po Lin

AU - Chiang, Tsuey Ru

AU - Lin, Shinn Kuang

AU - Yip, Bak Sau

AU - Chen, Chin I.

AU - Bai, Chi Huey

AU - Chen, Sien Tsong

AU - Chiou, Hung Yi

AU - Lien, Li Ming

AU - Hsu, Chung Y.

PY - 2017/4/1

Y1 - 2017/4/1

N2 - 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 hypercholesterol-emia. 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.

AB - 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 hypercholesterol-emia. 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.

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