Abstract 120: A Multicenter Study of the Prevalence and Outcomes of Intracranial Large Artery Atherosclerosis among Stroke and TIA Patients in China
BACKGROUND The prevalence, characteristics and outcomes of stroke patients with intracranial large artery atherosclerosis have not been clearly established by large multicenter prospective study.
METHODS In this prospective multicenter study, we evaluated 2864 consecutive patients (mean age, 62 years) who experienced an acute cerebral ischemia, including ischemic stroke or transient ischemic attack (TIA), within 7 days of symptom onset in 22 hospitals in China. All patients underwent magnetic resonance angiography (MRA), with measurement of diameter of the main intracranial arteries. Intracranial large artery atherosclerosis was defined as at least 50% diameter reduction on MRA. RESULTS The prevalence of intracranial stenosis was 46.6% (1,335 patients, including 261 patients with co-existing extracranial carotid stenosis). Patients with intracranial stenosis had more severe stroke at admission and stayed longer in hospitals than those without intracranial stenosis (median NIHSS 3 vs 5, ; median length of stay 14 vs 16 days respectively, both p<.0001). In hospital treatment included antithrombotics (96%), statins (76%), and antihypertensives (51%). After 12 months, recurrent stroke occurred in 3.34% of patients with no stenosis, 3.82% for 50-69% stenosis, 5.16% for 70-99% stenosis and 7.40% for 100% occlusion. Apart from the degree of arterial stenosis, age, family history of stroke, prior history of cerebral ischemia or heart disease and no prior use of antithrombotic drug were independent risk factors for recurrent stroke. The recurrent rate of each group of patients categorized by degree of stenosis and number of risk factor is shown in the Figure. The highest rate of recurrence was observed in patients with 100% occlusion with the presence of 3 additional risk factors.
CONCLUSION Intracranial large artery stenosis is the commonest vascular lesion in patients with cerebrovascular disease in China. Recurrent stroke rates remains high in patients with severe stenosis and other risk factors despite prevalent use of medical treatment such as antiplatelet, antihypertensive and statin therapies.
- © 2012 by American Heart Association, Inc.