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

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• 作者：Rui Fu ; MD^&lowast ; ; Yilong Wang ; MD^&dagger ; ; Yongjun Wang ; MD^&dagger ; ; ^{yongjunwang1962@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Liping Liu ; MD^&dagger ; ; Xingquan Zhao ; MD^&dagger ; ; David Z. Wang ; DO^&Dagger ; ; Yuesong Pan ; MD^&dagger ; ; Yuehua Pu ; MD^&dagger ; ; Changqing Zhang ; MD^&dagger ; ; on behalf of the Chinese IntraCranial AtheroSclerosis (CICAS) Study GroupXiaojun Zhang ; Xiaojiang Sun ; Qingke Bai ; Lan Yu ; Minxia Guo ; Qilin Ma ; Bo Xiao ; Le Zhang ; Zhong Zhang ; Anding Xu ; Xiaoping Pan ; Yefeng Cai ; Juntao Li ; Yiping Wu ; Jie Lin ; Chengming Xing ; Yuming Xu ; Benyan Luo ; Rongyuan Zheng ; Zhao Han ; Xiaodong Yuan ; Wanlin Cui ; Yuan Zou ; Heli Yan
• 关键词：Cortical microinfarcts ; intracranial atherosclerosis ; ischemic ; stroke
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2015
• 出版时间：November 2015
• 年：2015
• 卷：24
• 期：11
• 页码：2447-2454
• 全文大小：347 K

文摘

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.