Study on the Predictive Value of the Intracranial and Carotid Arteries Coexisting Atherosclerotic Plaque Distribution Characteristics for the Risk of Ischemic Stroke Recurrence
Objective To investigate the predictive value of intracranial and carotid arteries coexisting atherosclerotic plaque distribution characteristics for the risk of stroke recurrence.Methods Patients with ischemic stroke within 2 weeks and at least one carotid plaque were consecutively included and underwent multi-contrast MR vessel wall imaging for extracranial carotid arteries and MRA for intracranial arteries at baseline.All patients were followed up for at least 1 year to record stroke recurrence.The distribution characteristics of atherosclerotic plaque in different segments of the extracranial carotid artery and the incidence of coexisting intracranial artery stenosis in anterior circulation and extracranial carotid artery atherosclerotic plaques in different segments were analyzed.Univariate and multivariate Cox regressions were used to calculate the predictive value of coexisting intracranial artery stenosis in anterior circulation and carotid artery atherosclerotic plaques in different segments for stroke recurrence.Results A total of 117 patients were included,with a mean age of(62.6±11.8)years,including 85 males.The median follow-up time was 12.0(11.1-12.8)months,and 31(26.5％)patients experienced stroke recurrence.Coexisting intracranial artery stenosis in the anterior circulation and atherosclerotic plaques in the segment of the carotid bulb was significantly associated with stroke recurrence(HR 2.535,95％CI 1.085-5.922,P=0.032).After adjusting for confounding factors(age,sex,and BMI),this association remained statistically significant(HR 2.903,95％CI 1.114-7.565,P=0.029).No significant association was found between intracranial artery stenosis in anterior circulation coexistent with atherosclerotic plaque in other segments of the carotid artery and stroke recurrence(P＞0.05).Conclusions In patients with ischemic stroke and at least one carotid plaque,coexisting intracranial artery stenosis in anterior circulation and atherosclerotic plaque in the segment of the carotid bulb was independently associated with stroke recurrence.
万方数据
维普
