The Development of Cortical Microinfarcts Is Associated with Intracranial Atherosclerosis: Data from the Chinese Intracranial Atherosclerosis Study

Document Type

Article

Abstract

BACKGROUND: Little is known about the association between the cortical microinfarcts (CMIs) and intracranial atherosclerosis (ICAS) in Chinese patients with ischemic stroke. This study was designed to analyze the association and evaluate the role of CMIs in clinical outcomes. METHODS: We evaluated 1421 consecutive patients who had experienced an acute cerebral ischemia within 7 days after symptom onset and evaluated the presence of CMIs and ICAS based on patients' 3.0-T magnetic resonance imaging and magnetic resonance angiography scans. Baseline characteristics, patient risk factors, and clinical outcomes were analyzed to investigate the different outcomes between the CMIs (n = 209) group and non-CMIs (n = 1212) group. RESULTS: CMIs were present in 14.7% persons. The following parameters were associated with risk of CMIs: advanced age, National Institutes of Health Stroke Scale score on admission, lower level of systemic blood pressure, lower triglycerides level, ICAS, and cerebral microbleeds (CMBs). On multivariate logistic regression analysis, ICAS remained an independent risk factor for the development of CMIs (adjusted odds ratio, 1.493; 95% confidence interval, 1.022-2.182; P = .038). At the time point of 1 year after stroke, the rates of poor outcome (modified Rankin Scale, 3-6) in CMIs group (33.5%) were statistically significantly different from the non-CMIs group (22.6%; P = .001). In addition, patients in CMIs group had a significantly higher stroke recurrence rate than patients in the non-CMIs group (6.7% versus 4%; P = .085). CONCLUSIONS: The development of CMIs is strongly associated with ICAS. CMIs are independent predictors of poor prognosis in patients with ischemic stroke.

Medical Subject Headings

Adult; Age Factors; Aged; Aged, 80 and over; Brain Ischemia (complications); Cerebral Infarction (complications, diagnosis, epidemiology); China (epidemiology); Female; Humans; Imaging, Three-Dimensional; Intracranial Arteriosclerosis (complications, epidemiology, etiology); Magnetic Resonance Angiography; Magnetic Resonance Imaging; Male; Middle Aged; Retrospective Studies; Risk Factors; Severity of Illness Index; Stroke (complications, etiology); Young Adult

Publication Date

11-1-2015

Publication Title

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

E-ISSN

1532-8511

Volume

24

Issue

11

First Page

2447

Last Page

54

PubMed ID

26363706

Digital Object Identifier (DOI)

10.1016/j.jstrokecerebrovasdis.2015.03.011

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