Abstract W P108: The Burden and Topographic Distribution of Intracranial Atherosclerosis Predict Stroke Recurrence: A Longitudinal Study of Acute Ischemic Stroke Patients
Introduction: To date, it remains unclear whether the burden and topographic distribution of intracranial atherosclerosis (ICAS) predict subsequent stroke event.
Hypothesis: We assessed the hypothesis that the presence of advanced ICAS at the baseline is an independent biomarker to predict future stroke recurrence among acute ischemic stroke patients.
Methods: A total of 446 consecutive patients with ischemic stroke or transient ischemic attack (TIA) were included in this study. Cox proportional regression model was used to examine the association between the burden and topographic distribution of ICAS and subsequent ischemic stroke or TIA. Using the MRA findings at the baseline, we classified patients into 3 groups by the number of ICAS: 1) none (n=277); 2) single (n=88); and 3) two or more (n=81), and into 4 groups by the distribution of ICAS: 1) none (n=277); 2) anterior circulation territory (n=89); 3) posterior circulation territory (n=48); and 4) both circulation territories (n=32), respectively.
Results and Conclusions: The recurrence rate of ischemic stroke or TIA was 10.8% (n=48) over a median 4.6 years of follow-up. The presence of two or more ICAS (adjusted hazard ratio [HR]: 2.54, 95% CI: 1.31-4.92) and ICAS located in both circulation territories (HR: 3.27, 95% CI: 1.38-7.73) were independently associated with an increased risk of recurrence of ischemic stroke or TIA, after adjustment of vascular risk factors and secondary prevention medication. In conclusion, our findings suggest that advanced ICAS in acute ischemic stroke patients could be an independent predictor for recurrence of ischemic stroke or TIA.
Author Disclosures: B. Kim: None. G. Kim: None. O. Bang: None. K. Lee: None. C. Chung: None.
- © 2014 by American Heart Association, Inc.