Leptomeningeal collaterals are associated with modifiable metabolic risk factors.
Leptomeningeal collaterals are associated with modifiable metabolic risk factors.
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DOI：
10.1002/ana.23906
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发表时间：
2013-08
影响因子：
11.2
通讯作者：
Sohn, Sung Il
中科院分区：
文献类型：
--
作者：
Menon, Bijoy K.;Smith, Eric E.;Coutts, Shelagh B.;Welsh, Donald G.;Faber, James E.;Goyal, Mayank;Hill, Michael D.;Demchuk, Andrew M.;Damani, Zaheed;Cho, Kyung-Hee;Chang, Hyuk-Won;Hong, Jeong-Ho;Sohn, Sung Il
我们试图找出与急性缺血性卒中患者软脑膜侧支状态变异性相关的潜在可改变的决定因素。数据来自Keimyung中风登记处。纳入2004年5月至2009年7月连续行基线CT血管造影(CTA)检查的大脑中动脉(MCA)M1段±颈内动脉(ICA)闭塞患者。基线和随访的影像分析是在不考虑所有临床信息的情况下进行的。两名评价者使用先前验证的区域软脑膜评分(RLMC)，以共识的方式评估基线CTA上的软脑膜侧支。基线特征(n=206)：平均年龄66.9±11.6岁，平均基线NIHSS 14(IQR 11~20)，卒中症状起病至CTA 166分钟(IQR 96~262)，基线侧支状态差(rLMC评分0~10分)73/206(35.4%)。在单变量分析中，基线侧支状态较差的患者年龄较大、高血压、白细胞计数、血糖、D-二聚体、血清尿酸水平较高，更有可能出现代谢综合征。多变量模型确定代谢综合征(OR3.2295%CI1.69-6.15，p<；0.001)、高尿酸血症(每1 mg/dl或1.3595%CI1.12-1.62，p<；0.01)和高龄(每10年OR1.34 95%CI1.02-1.77，p=0.03)是基线时软脑膜侧支状态差的独立预测因素。代谢综合征、高尿酸血症和年龄与急性缺血性卒中患者软脑膜侧支循环状态差有关。
We seek to identify potentially modifiable determinants associated with variability in leptomeningeal collateral status in patients with acute ischemic stroke. Data are from the Keimyung Stroke Registry. Consecutive patients with M1 segment middle cerebral artery (MCA) ± intracranial internal carotid artery (ICA) occlusions on baseline CT-angiography (CTA) from May 2004 to July 2009 were included. Baseline and follow-up imaging was analyzed blinded to all clinical information. Two raters assessed leptomeningeal collaterals on baseline CTA by consensus, using a previously validated regional leptomeningeal score (rLMC). Baseline characteristics (n=206) were: mean age 66.9±11.6 years, median baseline NIHSS 14 (IQR 11-20), and median stroke symptom onset to CTA 166 minutes (IQR 96-262), Poor collateral status at baseline (rLMC score 0-10) was seen in 73/206 (35.4%). On univariate analyses, patients with poor collateral status at baseline were older, hypertensive, had higher white blood cell count, blood glucose, D-dimer, serum uric acid levels, and were more likely to have metabolic syndrome. Multivariable modeling identified metabolic syndrome (OR 3.22 95% CI 1.69-6.15, p<0.001), hyperuricemia (per 1 mg/dl OR 1.35 95% CI 1.12-1.62, p<0.01) and older age (per 10 years, OR 1.34 95% CI 1.02-1.77, p=0.03) as independent predictors of poor leptomeningeal collateral status at baseline. Metabolic syndrome, hyperuricemia and age are associated with poor leptomeningeal collateral status in patients with acute ischemic stroke.
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影响因子：
19.6
作者：
Khosla, UM;Zharikov, S;Johnson, RJ
通讯作者：
Johnson, RJ
影响因子：
4.2
作者：
Omura-Matsuoka, Emi;Yagita, Yoshiki;Kitagawa, Kazuo
通讯作者：
Kitagawa, Kazuo
影响因子：
8.3
作者：
ONEILL, PA;DAVIES, I;BENNETT, D
通讯作者：
BENNETT, D
影响因子：
11.2
作者：
Parsons, MW;Barber, PA;Davis, SM
通讯作者：
Davis, SM
影响因子：
8.3
作者：
Liebeskind, DS
通讯作者：
Liebeskind, DS