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Does all single infarction have lower risk of stroke recurrence than multiple infarctions in minor stroke?

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机构: [1]Beijing Tiantan Hosp, Beijing, Peoples R China; [2]Univ Calif San Francisco, Dept Neurol, San Francisco, CA USA; [3]Univ Calif San Francisco, Dept Epidemiol, San Francisco, CA 94143 USA; [4]Taizhou First Peoples Hosp, Taizhou, Peoples R China; [5]Taiyuan Iron & Steel Grp Co Ltd, Gen Hosp, Taiyuan, Shanxi, Peoples R China; [6]Dagang Oilfield Gengeal Hosp, Tianjin, Peoples R China; [7]Penglai Peoples Hosp, Penglai, Peoples R China; [8]Third Peoples Hosp Datong, Datong, Peoples R China; [9]Fourth Cent Hosp Tianjin, Tianjin, Peoples R China; [10]Hebei Med Univ, Hosp 2, Shijiazhuang, Hebei, Peoples R China; [11]First Hosp Fangshan Dist, Beijing, Peoples R China; [12]Beijing Puren Hosp, Beijing, Peoples R China; [13]Tianjin Ninghe Dist Hosp, Tianjin, Peoples R China; [14]Peoples Hosp Zhengzhou, Zhengzhou, Henan, Peoples R China; [15]North China Coal Med Coll, Affiliated Hosp, Tangshan, Peoples R China; [16]Zhejiang Zhoushan Hosp, Zhoushan, Peoples R China; [17]Han Dan Cent Hosp, Handan, Peoples R China; [18]Zhecheng Peoples Hosp, Zhecheng, Peoples R China; [19]Shanxi Med Univ, Hosp 2, Taiyuan, Shanxi, Peoples R China; [20]Baotou Cent Hosp, Baotou, Peoples R China; [21]Gen Hosp Changjiang River Shipping, Wuhan, Hubei, Peoples R China; [22]Dalian Econ & Technol Dev Zone Hosp, Dalian, Peoples R China; [23]North China Coal Med Coll, Affiliated Hosp, Neurol Dept 1, Tangshan, Peoples R China; [24]Zhengzhou Univ, Affiliated Hosp 1, Zhengzhou, Henan, Peoples R China; [25]First Affiliated Hosp Liaoning Med, Jinzhou, Peoples R China; [26]Lianyungang Municipal Hosp TCM, Lianyungang, Peoples R China; [27]Cent Hosp Qiu Cty, Handan, Peoples R China; [28]Tianjin First Ctr Hosp, Tianjin, Peoples R China; [29]Wuhan Univ, Renmin Hosp, Wuhan, Hubei, Peoples R China; [30]Qingdao Cent Hosp, Qingdao, Peoples R China; [31]Baogang Hosp, Baotou, Peoples R China; [32]Changzhi City Peoples Hosp Shanxi Prov, Changzhi, Peoples R China; [33]HaLixun Int Peace Hosp, Hengshui, Peoples R China; [34]Peoples Hosp Linzi Dist, Zibo, Peoples R China; [35]Yantai City Yantai Mt Hosp, Yantai, Peoples R China; [36]Beijing Pinggu Dist Hosp, Beijing, Peoples R China; [37]Taiyuan Cent Hosp, Taiyuan, Peoples R China; [38]Chengde Cent Hosp, Chengde, Peoples R China; [39]Shijiazhuang Cent Hosp, Shijiazhuang, Hebei, Peoples R China; [40]Dalian Municipal Cent Hosp, Neurol Dept 1, Dalian, Peoples R China; [41]Xian 141 Hosp, Xian, Shaanxi, Peoples R China; [42]Chengdu Third Municipal Peoples Hosp, Chengdu, Sichuan, Peoples R China; [43]Chifeng Univ, Affiliated Hosp, Chifeng, Peoples R China; [44]Zhengzhou Cent Hosp, Zhengzhou, Henan, Peoples R China; [45]Lihuili Hosp, Med Ctr, Ningbo, Zhejiang, Peoples R China; [46]Henan Prov Peoples Hosp, Zhengzhou, Henan, Peoples R China; [47]Jinzhong City Second Hosp, Jinzhong, Peoples R China; [48]Capital Med Univ, Beijing Anzhen Hosp, Beijing, Peoples R China; [49]Beijing Huairou Dist Chinese Med Hosp, Beijing, Peoples R China; [50]Hebei Med Univ, Hosp 3, Shijiazhuang, Hebei, Peoples R China; [51]Shanxi Med Univ, Affiliated Hosp 1, Taiyuan, Shanxi, Peoples R China; [52]Hebei Prov Peoples Hosp, Shijiazhuang, Hebei, Peoples R China; [53]Guangzhou First Municipal Peoples Hosp, Guangzhou, Guangdong, Peoples R China; [54]Cent Hosp Cangzhou, Cangzhou, Peoples R China; [55]Affiliated Hosp, Chinese Peoples Armed Police Force Med Sch, Beijing, Peoples R China; [56]Zhejiang Wenzhou Med Coll, First Affiliated Hosp, Wenzhou, Peoples R China; [57]Jilin Cent Hosp, Jilin, Jilin, Peoples R China; [58]Anhui Maanshan Cent Hosp, Maanshan, Peoples R China; [59]Beijing Aviat Ind Cent Hosp, Beijing, Peoples R China; [60]Luhe Hosp, Beijing, Peoples R China; [61]Capital Med Univ, Beijing Fuxing Hosp, Beijing, Peoples R China; [62]306th Hosp PLA, Beijing, Peoples R China; [63]Tianjin Univ Chinese Med, Affiliated 1, Tianjin, Peoples R China; [64]Baiqiuen Int Peace Hosp Peoples Liberat Army, Shijiazhuang, Hebei, Peoples R China; [65]China Med Univ, Affiliated Hosp 4, Taichung, Taiwan; [66]Cent S Univ, Xiangya Hosp, Changsha, Hunan, Peoples R China; [67]Tangshan Workers Hosp, Tangshan, Peoples R China; [68]1st Hosp Handan, Handan, Peoples R China; [69]Yangquan Coal Grp Co Ltd, Gen Hosp, Yangquan, Peoples R China; [70]Tianjin Tianhe Hosp, Tianjin, Peoples R China; [71]Nantong First Peoples Hosp, Nantong, Peoples R China; [72]1st Hosp Zhangjiakou City, Zhangjiakou, Peoples R China; [73]Sichuan Univ, West China Hosp, Chengdu, Sichuan, Peoples R China; [74]Shandong Univ TCM, Affiliated Hosp 2, Jinan, Shandong, Peoples R China; [75]Fenyang Hosp Shanxi Prov, Luliang, Peoples R China; [76]Zhejiang Zhoushan Putuo Dist Peoples Hosp, Zhoushan, Peoples R China; [77]China Acad Chinese Tradit Med, Xiyuan Hosp, Beijing, Peoples R China; [78]2 Peoples Hosp East Lianyungang City, Lianyungang, Peoples R China; [79]Qingdao Univ, Coll Med, Affiliated Hosp, Qingdao, Peoples R China; [80]Shandong Univ, Qilu Hosp, Jinan, Shandong, Peoples R China; [81]Zibo Hosp Tradit Chinese Med, Zibo, Peoples R China; [82]Beijing Shijitan Hosp, Beijing, Peoples R China; [83]Beijing Haidian Hosp, Beijing, Peoples R China; [84]Beijing Shunyi Dist Hosp, Beijing, Peoples R China; [85]Dalian Third Municipal Hosp, Dalian, Peoples R China; [86]Jinan Univ, Affliated Hosp 1, Jinan, Shandong, Peoples R China; [87]Navy Gen Hosp PLA, Beijing, Peoples R China; [88]Beijing Second Artillery Gen Hosp, Beijing, Peoples R China; [89]Beijing Daxing Dist Hosp, Beijing, Peoples R China; [90]Sichuan Prov Peoples Hosp, Chengdu, Sichuan, Peoples R China; [91]Dalian Municipal Cent Hosp, Dalian, Peoples R China; [92]Second Hosp Baoding, Baoding, Peoples R China; [93]Hosp Combine Tradit Chinese & Western Med Cang Zh, Cang Zhou, Peoples R China; [94]309th Hosp PLA, Beijing, Peoples R China; [95]Liangxiang Hosp Fangshan Dist, Beijing, Peoples R China; [96]Tsinghua Univ, HuaXin Hosp Hosp 1, Beijing, Peoples R China; [97]Tianjin Huanhu Hosp, Tianjin, Peoples R China; [98]Shijiazhuang First Hosp, Shijiazhuang, Hebei, Peoples R China; [99]Xinzhou City Peoples Hosp, Xinzhou, Peoples R China; [100]Sichuan Prov Peoples Hosp Deyang City, Deyang, Peoples R China; [101]Jilin Univ, Hosp 1, Jilin, Jilin, Peoples R China; [102]Shandong Prov Hosp, Jinan, Shandong, Peoples R China; [103]Fujian Prov Hosp, Fuzhou, Fujian, Peoples R China; [104]Liaoyang City Third Peoples Hosp, Liaoyang, Peoples R China; [105]Handan City Ctr Hosp, Handan, Peoples R China; [106]Capital Med Univ, Beijing Chaoyang Hosp, Beijing, Peoples R China; [107]Beijing Univ Chinese Med, East Hosp, Beijing, Peoples R China; [108]Hebei Med Univ, Hosp 4, Shijiazhuang, Hebei, Peoples R China; [109]Soochow Univ, Affiliated Hosp 4, Suzhou, Peoples R China; [110]Zhejiang Univ Chinese Med, Affiliated Hosp 1, Hangzhou, Zhejiang, Peoples R China; [111]Kailuan Co Ltd, Affiliated Hosp, Tangshan, Peoples R China; [112]Weifang Med Univ, Affiliated Hosp, Weifang, Peoples R China; [113]Harbin Med Univ, Hosp 1, Harbin, Heilongjiang, Peoples R China; [114]Dalian Friendship Hosp, Dalian, Peoples R China; [115]Tianjin Dagang Hosp, Tianjin, Peoples R China; [116]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, Beijing, Peoples R China; [117]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China; [118]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China; [119]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China; [120]Univ Illinois, Coll Med, Sisters 3 Order St Francis Healthcare Syst, Illinois Neurol Inst Stroke Network, Peoria, IL 61656 USA
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关键词: Minor stroke Infarction patterns Prognosis

摘要:
BackgroundSingle acute infarction (SAI) usually had lower risk of stroke recurrence than multiple acute infarctions (MAIs) in minor stroke. To evaluate whether all SAI had lower risk of stroke recurrence than MAIs in minor stroke.MethodsWe derived data from the imaging subgroup of the Clopidogrel in High-risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial. Minor stroke were categorized into SAI and MAIs by infarction numbers in diffusion weighted imaging. SAI were classified as lacunar infarction and non-lacunar infarction. The outcome was stroke recurrence within one-year follow-up. We assessed the associations between infarction patterns and stroke recurrence using multivariable Cox regression models.ResultsOverall, 834 patients with minor stroke were included in this subgroup, 553 SAI (381 lacunar infarction, 172 non-lacunar infarction) and 281 MAIs. The rate of stroke recurrence was 7.6%, 15.1% and 15.3% in lacunar infarction of SAI, non-lacunar infarction of SAI and MAIs at one year, respectively. Compared with MAIs, lacunar infarction of SAI had lower risk of stroke recurrence (hazard ratio [HR] 0.41, 95% confidence interval [CI] 0.21-0.80, P=0.009), but not in non-lacunar infarction of SAI (HR 1.01, 95% CI 0.60-1.69, P=0.98).ConclusionsLacunar infarction of SAI have lower risk of stroke recurrence than MAIs, while non-lacunar infarction of SAI might have similar risk as MAIs. Except for the number of infarctions, size and location should also be considered to stratify risk of stroke recurrence in minor stroke.Trial registrationhttp://www.clinicaltrials.gov Unique identifier: NCT00979589. Date of registration: September 2009.

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出版当年[2018]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学
最新[2023]版:
大类 | 3 区 医学
小类 | 4 区 临床神经病学
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出版当年[2017]版:
Q3 CLINICAL NEUROLOGY
最新[2023]版:
Q3 CLINICAL NEUROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2017版] 出版当年五年平均 出版前一年[2016版] 出版后一年[2018版]

第一作者:
第一作者机构: [116]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, Beijing, Peoples R China; [117]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China; [118]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China; [119]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China;
通讯作者:
通讯机构: [1]Beijing Tiantan Hosp, Beijing, Peoples R China; [116]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, Beijing, Peoples R China; [117]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China; [118]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China; [119]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China;
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