This Article Full Text Full Text (PDF) All Versions of this Article: 38/7/2085    most recent STROKEAHA.107.482950v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ois, A. Articles by Roquer, J. Search for Related Content PubMed PubMed Citation Articles by Ois, A. Articles by Roquer, J. Related Collections Acute Cerebral Infarction Doppler ultrasound, Transcranial Doppler etc.

(Stroke. 2007;38:2085.)
© 2007 American Heart Association, Inc.

Original Contributions

Early Arterial Study in the Prediction of Mortality After Acute Ischemic Stroke

Angel Ois, MD; Elisa Cuadrado-Godia, MD; Jordi Jiménez-Conde, MD; Meritxell Gomis, MD; Ana Rodríguez-Campello, MD; Jose E. Martínez-Rodríguez, MD; Elvira Munteis, MD Jaume Roquer, MD, PhD

From the Unitat d’Ictus, Servei de Neurologia, Hospital del Mar, Departament de Medicina, Universitat Autònoma de Barcelona, IMIM-Hospital del Mar. Barcelona, Barcelona, Spain.

Correspondence to Angel Ois, MD, Servicio de Neurología, Hospital del Mar, Passeig Maritim 25-29, 08003, Barcelona, Spain. E-mail 94545{at}imas.imim.es

Background and Purpose— The purpose of this study was to evaluate the value of the initial arterial study as a predictor of 90-day mortality in patients with acute ischemic stroke.

Methods— A total of 1220 unselected patients assessed during the first 24 hours after stroke onset were prospectively studied. Initial stroke severity was evaluated by the National Institutes of Health Stroke Scale and dichotomized in mild (National Institutes of Health Stroke Scale 7) and severe (National Institutes of Health Stroke Scale >7). Severe arterial stenosis (70%) or arterial occlusion in the symptomatic territory was determined by a Doppler study and also by additional explorations (carotid duplex, MR or CT angiography) in the first 24 hours after admission. The following variables were also analyzed: age, gender, previous functional status, smoking, hypertension, hyperlipidemia, diabetes mellitus, peripheral arterial disease, ischemic heart disease, heart failure, atrial fibrillation, previous stroke, and prior use of antithrombotic or statins. Ninety-day mortality was the end point of the study.

Results— Ninety-day mortality was 15.7%. A total of 25.5% of all deaths were in patients with mild stroke. In addition to well-known factors related to mortality (age, stroke severity, ischemic heart disease, heart failure, and previous disability), severe arterial stenosis/occlusion was the factor with the highest relationship with 90-day mortality (adjusted OR: stenosis 2.13, occlusion 4.42, both 3.36). Arterial stenosis/occlusion was a higher predictor of 90-day mortality in patients with mild (adjusted OR: 5.38) than severe stroke (adjusted OR: 3.05).

Conclusions— Severe arterial stenosis/occlusion in the early arterial study was highly related with 90-day mortality in an unselected series of patients with stroke. These data achieve special relevance in patients with initial mild stroke.

Key Words: acute stroke • Doppler • outcome

This article has been cited by other articles:

				M. Gomis, T. Sobrino, A. Ois, M. Millan, A. Rodriguez-Campello, N. P. de la Ossa, R. Rodriguez-Gonzalez, J. Jimenez-Conde, E. Cuadrado-Godia, J. Roquer, et al. Plasma {beta}-Amyloid 1-40 Is Associated With the Diffuse Small Vessel Disease Subtype Stroke, October 1, 2009; 40(10): 3197 - 3201. [Abstract] [Full Text] [PDF]

				A. Ois, M. Gomis, A. Rodriguez-Campello, E. Cuadrado-Godia, J. Jimenez-Conde, C. Pont-Sunyer, G. Cuccurella, and J. Roquer Factors Associated With a High Risk of Recurrence in Patients With Transient Ischemic Attack or Minor Stroke Stroke, June 1, 2008; 39(6): 1717 - 1721. [Abstract] [Full Text] [PDF]