Association of multiple infarctions and ICAS with outcomes of minor stroke and TIA.

Document Type

Article

Abstract

OBJECTIVE: To estimate the association of different patterns of infarction and intracranial arterial stenosis (ICAS) with the prognosis of acute minor ischemic stroke and TIA.

METHODS: We derived data from the Clopidogrel in High-risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial. A total of 1,089 patients from 45 of 114 participating sites of the trial undergoing baseline MRI/angiography were included in this subgroup analysis. Patterns of infarction and ICAS were recorded for each individual. The primary efficacy outcome was an ischemic stroke at the 90-day follow-up. We assessed the associations between imaging patterns and prognosis of patients using multivariable Cox regression models.

RESULTS: Among the 1,089 patients included in this subgroup analysis, 93 (8.5%) patients had a recurrent ischemic stroke at 90 days. Compared with those without infarction or ICAS, patients with single infarction with ICAS (11.9% vs 1.3%, hazard ratio [HR] 6.25, 95% confidence intervals [CIs] 1.40-27.86,

CONCLUSIONS: The presence of multiple infarctions and ICAS were both associated with an increased risk of 90-day ischemic stroke in patients with minor stroke or TIA, while the presence of both imaging features had a combined effect.

CLINICALTRIALSGOV IDENTIFIER: NCT00979589.

Medical Subject Headings

Aged; Aspirin; Brain; Brain Infarction; Brain Ischemia; Clopidogrel; Female; Humans; Image Processing, Computer-Assisted; Intracranial Arteriosclerosis; Ischemic Attack, Transient; Male; Middle Aged; Platelet Aggregation Inhibitors; Stroke; Ticlopidine; Treatment Outcome

Publication Date

3-14-2017

Publication Title

Neurology

ISSN

1526-632X

Volume

88

Issue

11

First Page

1081

Last Page

1088

PubMed ID

28202699

Digital Object Identifier (DOI)

10.1212/WNL.0000000000003719

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