Impact of revascularization therapies on outcome of posterior circulation ischemic stroke: The Indo-US stroke project.
Impact of revascularization therapies on outcome of posterior circulation ischemic stroke: The Indo-US stroke project.
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DOI：
10.1016/j.jns.2021.117499
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发表时间：
2021-08-15
影响因子：
4.4
通讯作者：
Singhal AB
中科院分区：
文献类型：
--
作者：
Nair SS;Sylaja PN;Pandian J;Srivastava MVP;Khurana D;Kaul S;Arora D;Sarma PS;Khatter H;Singhal AB
后循环卒中（PCS）的研究不如前循环卒中（ACS）广泛，尤其是关于血运重建治疗。我们在一项大型前瞻性多中心印度卒中登记研究中分析了PCS和ACS在基线卒中特征、血运重建治疗和3个月结局方面的差异。2012年1月至2014年8月在印度-美国合作卒中项目中招募的急性缺血性卒中患者根据成像确认的梗死位置分为PCS和ACS。比较了人口统计学、卒中严重程度、危险因素和机制。我们进一步比较了接受血运重建治疗（RT）和未接受血运重建治疗（NRT）的亚组中的这些参数。主要结局为3个月改良兰金量表（mRS）。在1889例患者（1270例男性）中，1478例（78.2%）患有ACS，411例（21.8%）患有PCS。PCS的中位NIHSS较低（7 vs 11，p<0.001）。PCS以糖尿病、高血压多见，ACS以风湿性心脏病多见。PCS的小动脉闭塞率较高（23.8% vs 12.9%，p<0.001）。仅28例（6.8%）PCS接受RT，而ACS为213例（14.4%）。在90天时，NRT组PCS的良好功能结局（mRS 0-2）更常见（56.4% vs 45.9%，p<0.001），而RT组无显著差异。在回归分析中，卒中区域不是3个月结局的独立预测因素。两组的住院死亡率没有差异。ACS和PCS的3个月功能结局和住院死亡率无差异。与ACS相比，PCS接受血运重建治疗的频率较低。
Posterior circulation strokes (PCS) have been less extensively studied than anterior circulation strokes (ACS), especially regarding revascularization therapies. We analyzed the differences in baseline stroke characteristics, revascularization therapy and 3-month outcomes between PCS and ACS in a large prospective multicentre Indian stroke registry. Patients with acute ischemic stroke recruited in the Indo-US collaborative stroke project from January 2012 to August 2014 were classified into PCS and ACS based on imaging-confirmed infarct location. Demographics, stroke severity, risk factors, and mechanisms were compared. We further compared these parameters in the subgroups who received revascularization therapies (RT) and no revascularization therapies (NRT). The primary outcome was 3-month modified Rankin scale (mRS). Of 1889 patients (1270 males), 1478 (78.2%) had ACS and 411 (21.8%) PCS. The median NIHSS was lower in PCS (7 vs 11, p<0.001). Diabetes mellitus and hypertension were more common in PCS and rheumatic heart disease in ACS. Small artery occlusion was higher in PCS (23.8% vs 12.9%, p<0.001). Only 28 (6.8%) PCS received RT compared to 213 (14.4%) ACS. At 90 days, a good functional outcome (mRS 0–2) was more common in PCS (56.4% vs 45.9%, p<0.001) in NRT group, while no significant difference was noted in RT group. Stroke territory was not an independent predictor of 3-month outcome in regression analysis. In-hospital mortality was not different between the groups. The 3-month functional outcome and in-hospital mortality were not different between ACS and PCS. Compared to ACS, PCS received revascularization therapies less often.
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影响因子：
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通讯作者：
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