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Role of Circadian Rhythm Changes on Functional Dependence Despite Successful Repercussion in Patients with Endovascular Treatment

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机构: [1]Capital Med Univ, Xuanwu Hosp, Dept Neurol, Beijing, Peoples R China [2]Sichuan Prov Peoples Hosp, Dept Hlth Med Ctr, Chengdu, Sichuan, Peoples R China [3]Capital Med Univ, Beijing ShiJiTan Hosp, Dept Rehabil Med, Beijing, Peoples R China [4]Zhejiang Prov Peoples Hosp, Dept Neurol, Hangzhou, Zhejiang, Peoples R China [5]Capital Med Univ, Xuanwu Hosp, Beijing Key Lab Hypoxia Conditioning Translat Med, Beijing, Peoples R China [6]Capital Med Univ, Emergency Dept, Xuanwu Hosp, Beijing, Peoples R China [7]Capital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R China [8]Capital Med Univ, Collaborat Innovat Ctr Brain Disorders, Beijing Adv Innovat Ctr Big Data based Precis Med, Minist Sci & Technol,Lab Brain Disorders,Lab Clin, Beijing, Peoples R China
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关键词: AIS endovascular treatment futile recanalization circadian rhythm outcome LVO

摘要:
Background Increasing evidence of circadian biology may influence the physiopathologic mechanism, progression, and recovery of stroke. However, few data have shown about circadian rhythm on futile recanalization (FR) in patients treated with endovascular treatment (EVT). Methods From 2017 to 2021, an observational cohort of acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) underwent EVT was conducted. FR was defined as the failure to achieve functional independence in patients at 90 days after EVT, although the occluded vessels reached a recanalization. The effect of circadian rhythm on FR was investigated using the logistic regression model. Results Of 783 patients, there were 149 patients who had stroke onset between 23:00-6:59, 318 patients between 7:00-14:59, and 316 patients between 15:00-22:59. Patients suffered from stroke during 15:00-22:59 had shorter OTP (p =0.001) time, shorter OTR (p<0.001) time, higher rate of intravenous thrombolysis (p =0.001) than groups of other time intervals. The rate of FR post-EVT in patients who had a stroke between 15:00-22:59 was significantly higher than in those with stroke onset between 23:00-6:59 (p =0.017). After adjusting for confounding factors, the time of stroke occurring during 15:00-22:59 (adjusted OR [aOR], 1.652; 95%CI, 1.024-2.666, p =0.04) was an independent predictor of FR. Conclusion Circadian rhythm can directly or indirectly affect the occurrence, development, and prognosis of AIS. More studies may be needed in the future to validate the results of our study and to explore the potential mechanisms behind the effects of circadian rhythms on FR.

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基金编号: 82027802 2022YFC3602401

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出版当年[2023]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 神经科学
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 神经科学
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出版当年[2022]版:
Q4 CLINICAL NEUROLOGY Q4 NEUROSCIENCES
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Q3 CLINICAL NEUROLOGY Q3 NEUROSCIENCES

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第一作者机构: [1]Capital Med Univ, Xuanwu Hosp, Dept Neurol, Beijing, Peoples R China
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通讯机构: [7]Capital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R China [8]Capital Med Univ, Collaborat Innovat Ctr Brain Disorders, Beijing Adv Innovat Ctr Big Data based Precis Med, Minist Sci & Technol,Lab Brain Disorders,Lab Clin, Beijing, Peoples R China
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