Symptomatic steno-occlusion of cerebral arteries and subsequent ischemic events in patients with acute ischemic stroke

Jihoon Kang, Nayoung Kim, Chang W. Oh, O. Ki Kwon, Chol K. Jung, Wook Joo Kim, Jung H. Park, Youngchai Ko, Won Young Noh, Min U. Jang, Jeong Ho Hong, Ji S. Lee, Juneyoung Lee, Myung S. Jang, Mi H. Yang, Moon Ku Han, Hee Joon Bae

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background We aimed to assess the impact of symptomatic steno-occlusion (SYSO) of cerebral arteries and its characteristics on subsequent ischemic event (SIE) in patients with acute ischemic stroke. Methods Using a prospective stroke registry database, we identified consecutive patients with ischemic stroke who were hospitalized within 48 hours of symptom onset. SYSO denoted significant stenosis or occlusion of major cerebral arteries with ischemic lesions at the corresponding arterial territories and was characterized by its location and severity. Primary outcome was SIE that was defined as ischemic progression or recurrence within 1 year. Results In total, 1546 patients (age, 67.4 ± 13.0 years; median National Institutes of Health Stroke Scale score, 4) were enrolled in this study. The cumulative risk of SIE was 14.5% at 7 days, 14.9% at 14 days, 15.5% at 90 days, and 16.9% at 1 year. Patients with SYSO had significantly higher SIE rates compared with those without SYSO (23.0% versus 11.6%). Of the characteristics of SYSO, the location, not the severity, was significantly associated with SIE (P <.001 and P =.186, respectively). Multiple (adjusted hazard ratio, 5.85; 95% confidence interval, 1.81-18.85), intracranial internal carotid artery (ICA) (3.54; 1.21-8.21), and extracranial ICA SYSO (2.88; 1.01-8.21) raised the risk of SIE. Conclusions Subsequent cerebral ischemic events (progression or recurrence) after an acute ischemic stroke occur mostly within several days of stroke onset and is associated with the location, but not the severity, of symptomatic steno-occlusion of cerebral arteries. Crown

Original languageEnglish
JournalJournal of Stroke and Cerebrovascular Diseases
Volume23
Issue number5
DOIs
Publication statusPublished - 2014 Jan 1

Fingerprint

Cerebral Arteries
Stroke
Internal Carotid Artery
Recurrence
National Institutes of Health (U.S.)
Crowns
Registries
Pathologic Constriction
Databases
Confidence Intervals

Keywords

  • Ischemia
  • occlusion
  • prognosis
  • stenosis
  • stroke

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Symptomatic steno-occlusion of cerebral arteries and subsequent ischemic events in patients with acute ischemic stroke. / Kang, Jihoon; Kim, Nayoung; Oh, Chang W.; Kwon, O. Ki; Jung, Chol K.; Kim, Wook Joo; Park, Jung H.; Ko, Youngchai; Noh, Won Young; Jang, Min U.; Hong, Jeong Ho; Lee, Ji S.; Lee, Juneyoung; Jang, Myung S.; Yang, Mi H.; Han, Moon Ku; Bae, Hee Joon.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 23, No. 5, 01.01.2014.

Research output: Contribution to journalArticle

Kang, J, Kim, N, Oh, CW, Kwon, OK, Jung, CK, Kim, WJ, Park, JH, Ko, Y, Noh, WY, Jang, MU, Hong, JH, Lee, JS, Lee, J, Jang, MS, Yang, MH, Han, MK & Bae, HJ 2014, 'Symptomatic steno-occlusion of cerebral arteries and subsequent ischemic events in patients with acute ischemic stroke', Journal of Stroke and Cerebrovascular Diseases, vol. 23, no. 5. https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.12.028
Kang, Jihoon ; Kim, Nayoung ; Oh, Chang W. ; Kwon, O. Ki ; Jung, Chol K. ; Kim, Wook Joo ; Park, Jung H. ; Ko, Youngchai ; Noh, Won Young ; Jang, Min U. ; Hong, Jeong Ho ; Lee, Ji S. ; Lee, Juneyoung ; Jang, Myung S. ; Yang, Mi H. ; Han, Moon Ku ; Bae, Hee Joon. / Symptomatic steno-occlusion of cerebral arteries and subsequent ischemic events in patients with acute ischemic stroke. In: Journal of Stroke and Cerebrovascular Diseases. 2014 ; Vol. 23, No. 5.
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abstract = "Background We aimed to assess the impact of symptomatic steno-occlusion (SYSO) of cerebral arteries and its characteristics on subsequent ischemic event (SIE) in patients with acute ischemic stroke. Methods Using a prospective stroke registry database, we identified consecutive patients with ischemic stroke who were hospitalized within 48 hours of symptom onset. SYSO denoted significant stenosis or occlusion of major cerebral arteries with ischemic lesions at the corresponding arterial territories and was characterized by its location and severity. Primary outcome was SIE that was defined as ischemic progression or recurrence within 1 year. Results In total, 1546 patients (age, 67.4 ± 13.0 years; median National Institutes of Health Stroke Scale score, 4) were enrolled in this study. The cumulative risk of SIE was 14.5{\%} at 7 days, 14.9{\%} at 14 days, 15.5{\%} at 90 days, and 16.9{\%} at 1 year. Patients with SYSO had significantly higher SIE rates compared with those without SYSO (23.0{\%} versus 11.6{\%}). Of the characteristics of SYSO, the location, not the severity, was significantly associated with SIE (P <.001 and P =.186, respectively). Multiple (adjusted hazard ratio, 5.85; 95{\%} confidence interval, 1.81-18.85), intracranial internal carotid artery (ICA) (3.54; 1.21-8.21), and extracranial ICA SYSO (2.88; 1.01-8.21) raised the risk of SIE. Conclusions Subsequent cerebral ischemic events (progression or recurrence) after an acute ischemic stroke occur mostly within several days of stroke onset and is associated with the location, but not the severity, of symptomatic steno-occlusion of cerebral arteries. Crown",
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T1 - Symptomatic steno-occlusion of cerebral arteries and subsequent ischemic events in patients with acute ischemic stroke

AU - Kang, Jihoon

AU - Kim, Nayoung

AU - Oh, Chang W.

AU - Kwon, O. Ki

AU - Jung, Chol K.

AU - Kim, Wook Joo

AU - Park, Jung H.

AU - Ko, Youngchai

AU - Noh, Won Young

AU - Jang, Min U.

AU - Hong, Jeong Ho

AU - Lee, Ji S.

AU - Lee, Juneyoung

AU - Jang, Myung S.

AU - Yang, Mi H.

AU - Han, Moon Ku

AU - Bae, Hee Joon

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background We aimed to assess the impact of symptomatic steno-occlusion (SYSO) of cerebral arteries and its characteristics on subsequent ischemic event (SIE) in patients with acute ischemic stroke. Methods Using a prospective stroke registry database, we identified consecutive patients with ischemic stroke who were hospitalized within 48 hours of symptom onset. SYSO denoted significant stenosis or occlusion of major cerebral arteries with ischemic lesions at the corresponding arterial territories and was characterized by its location and severity. Primary outcome was SIE that was defined as ischemic progression or recurrence within 1 year. Results In total, 1546 patients (age, 67.4 ± 13.0 years; median National Institutes of Health Stroke Scale score, 4) were enrolled in this study. The cumulative risk of SIE was 14.5% at 7 days, 14.9% at 14 days, 15.5% at 90 days, and 16.9% at 1 year. Patients with SYSO had significantly higher SIE rates compared with those without SYSO (23.0% versus 11.6%). Of the characteristics of SYSO, the location, not the severity, was significantly associated with SIE (P <.001 and P =.186, respectively). Multiple (adjusted hazard ratio, 5.85; 95% confidence interval, 1.81-18.85), intracranial internal carotid artery (ICA) (3.54; 1.21-8.21), and extracranial ICA SYSO (2.88; 1.01-8.21) raised the risk of SIE. Conclusions Subsequent cerebral ischemic events (progression or recurrence) after an acute ischemic stroke occur mostly within several days of stroke onset and is associated with the location, but not the severity, of symptomatic steno-occlusion of cerebral arteries. Crown

AB - Background We aimed to assess the impact of symptomatic steno-occlusion (SYSO) of cerebral arteries and its characteristics on subsequent ischemic event (SIE) in patients with acute ischemic stroke. Methods Using a prospective stroke registry database, we identified consecutive patients with ischemic stroke who were hospitalized within 48 hours of symptom onset. SYSO denoted significant stenosis or occlusion of major cerebral arteries with ischemic lesions at the corresponding arterial territories and was characterized by its location and severity. Primary outcome was SIE that was defined as ischemic progression or recurrence within 1 year. Results In total, 1546 patients (age, 67.4 ± 13.0 years; median National Institutes of Health Stroke Scale score, 4) were enrolled in this study. The cumulative risk of SIE was 14.5% at 7 days, 14.9% at 14 days, 15.5% at 90 days, and 16.9% at 1 year. Patients with SYSO had significantly higher SIE rates compared with those without SYSO (23.0% versus 11.6%). Of the characteristics of SYSO, the location, not the severity, was significantly associated with SIE (P <.001 and P =.186, respectively). Multiple (adjusted hazard ratio, 5.85; 95% confidence interval, 1.81-18.85), intracranial internal carotid artery (ICA) (3.54; 1.21-8.21), and extracranial ICA SYSO (2.88; 1.01-8.21) raised the risk of SIE. Conclusions Subsequent cerebral ischemic events (progression or recurrence) after an acute ischemic stroke occur mostly within several days of stroke onset and is associated with the location, but not the severity, of symptomatic steno-occlusion of cerebral arteries. Crown

KW - Ischemia

KW - occlusion

KW - prognosis

KW - stenosis

KW - stroke

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