Aortic arch atherosclerosis in ischaemic stroke of unknown origin affects prognosis.
Aortic arch atherosclerosis in ischaemic stroke of unknown origin affects prognosis.
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DOI：
10.1159/000362434
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发表时间：
2014-01
影响因子：
1.9
通讯作者：
Katayama Y
中科院分区：
文献类型：
--
作者：
Abe A;Harada-Abe M;Ueda M;Katano T;Nakajima M;Muraga K;Suda S;Nishiyama Y;Okubo S;Mishina M;Katsura K;Katayama Y
入院时不明原因的脑梗死占某些机构所有脑梗死病例的一半。然而，与脑梗死预后相关的因素尚未得到充分的研究。在此，我们研究了经食管超声心动图（TOE）显示的主动脉弓斑块（AAP）是否与入院时不明原因脑梗死的预后相关。在2009年6月至2011年9月期间住院的571例患者中，149例（年龄：67 ± 14岁; 95例男性）入院时发生不明原因脑梗死的患者接受了TOE，并入组本研究。我们检查了他们的临床特征，24小时心电图检测到的间歇性房颤的发生率，以及医院颈动脉的超声心动图结果。不良预后结局定义为90天后改良兰金量表评分≥3分。总的来说，110名患者（74%）表现出良好的预后，39名患者（26%）表现出不良结局。入院时美国国立卫生研究院卒中量表评分>6 [比值比（OR）= 6.77; 95%置信区间（CI）：2.59-18.8; p < 0.001]，AAP ≥4 mm（OR = 2.75; 95%CI：1.19-6.91; p = 0.024）与入院时不明原因脑梗死的不良预后显著相关。厚AAPs可能是入院时不明原因脑梗死预后不良的一个预测因素。需要建立致脑栓塞的国际标准。未来的前瞻性研究应检查原因不明的脑梗死。
Cerebral infarction of unknown origin at admission accounts for half of all cerebral infarction cases in some institutions. However, the factors associated with cerebral infarction prognosis have not been sufficiently examined. Here, we investigated whether aortic arch plaques (AAPs) on transoesophageal echocardiography (TOE) were associated with the prognosis of cerebral infarction of unknown origin at admission. Of 571 patients who were hospitalised between June 2009 and September 2011, 149 (age: 67 ± 14 years; 95 men) with cerebral infarctions of unknown origin at admission underwent TOE and were enrolled in this study. We examined their clinical characteristics, the incidence of intermittent atrial fibrillation detected on 24-hour electrocardiography, and the echographic findings of the carotid artery in the hospital. A poor prognostic outcome was defined as a modified Rankin Scale score of ≥3 after 90 days. In all, 110 patients (74%) showed good prognoses and 39 patients (26%) showed poor outcomes. A National Institutes of Health Stroke Scale score of >6 on admission [odds ratio (OR) = 6.77; 95% confidence interval (CI): 2.59-18.8; p < 0.001] and AAPs of ≥4 mm (OR = 2.75; 95% CI: 1.19-6.91; p = 0.024) showed significant associations with a poor prognosis of cerebral infarction of unknown origin at admission. Thick AAPs could be a factor in the prediction of a poor prognosis of cerebral infarction of unknown origin at admission. The establishment of international standards for aortogenic brain embolisms is required. Future prospective studies should examine cerebral infarctions of unknown origin.
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影响因子：
9.9
作者：
DiTullio, MR;Sacco, RL;Homma, S
通讯作者：
Homma, S
影响因子：
158.5
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AMARENCO, P;COHEN, A;BOUSSER, MG
通讯作者：
BOUSSER, MG
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6.7
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Reid, John M.;Gubitz, Gord J.;Phillips, Stephen J.
通讯作者：
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作者：
FIORELLI, M;ALPEROVITCH, A;FIESCHI, C
通讯作者：
FIESCHI, C
影响因子：
9.9
作者：
Adams, HP;Davis, PH;Hansen, MD
通讯作者：
Hansen, MD