Comparison of the Chinese ischemic stroke subclassification and Trial of Org 10172 in acute stroke treatment systems in minor stroke

Tan, Sha; Zhang, Lei; Chen, Xiaoyu; Wang, Yanqiang; Lin, Yinyao; Cai, Wei; Shan, Yingchun; Qiu, Wei; Lu, Zhengqi

doi:10.1186/s12883-016-0688-y

Cited by 8 publications

(4 citation statements)

References 29 publications

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“…To explore whether the effects of RAGE and HMGB1 gene variants are confined to a specific subtype or related to overall risk, we further separated the IS patient groups into stroke subgroups based on the CISS system [ 28 ]. The CISS system, which further classifies patients of minor stroke into known and precise aetiological categories, exhibits greater reliability for individual treatment and might therefore be more appropriate for use with Chinese patients with minor stroke [ 29 ]. As shown in Table 5 , when the population was stratified according to the CISS classification system, the carriers of the TT allele at the RAGE rs2070600 variant appeared to have a higher risk of stroke of the large artery atherosclerosis (LAA) subtype compared with the controls (P = 0.036).…”

Section: Resultsmentioning

confidence: 99%

Genetic predisposition to ischaemic stroke by RAGE and HMGB1 gene variants in Chinese Han population

Zhu

Chen

et al. 2017

Oncotarget

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Emerging evidence suggests that the multiligand receptor for advanced glycation end products (RAGE) and its ligand high mobility group box 1 protein (HMGB1) contribute to the pathophysiology of ischaemic stroke (IS). The present study aimed to investigate the association of RAGE and HMGB1 variants with the risk of IS. A total of 1,034 patients and 1,015 age- and sex-matched healthy controls were genotyped to detect five genetic variants of the RAGE gene and four genetic variants of the HMGB1 gene using the Multiplex SNaPshot assay. We found that the rs2070600 variant of RAGE was associated with an increased risk of IS (OR = 1.19, 95% CI: 1.02-1.38, P = 0.043), whereas the rs2249825 variant of HMGB1 was associated with a decreased risk of IS (OR = 0.83, 95% CI: 0.71-0.98, P = 0.041). Further stratification by IS subtypes revealed that the presence of the TT genotype of the RAGE rs2070600 variant confers a higher risk of the large artery atherosclerosis subtype of IS (P = 0.036). Moreover, patients with the variant T allele of the RAGE rs2070600 variant presented with reduced serum soluble RAGE production. Patients carrying the variant G allele of the HMGB1 rs2249825 variant exhibited significantly lower infarct volumes than those with the major CC genotype. These clues may help in the development of optimal personalized therapeutic approaches for IS patients.

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Section: Resultsmentioning

confidence: 99%

Genetic predisposition to ischaemic stroke by RAGE and HMGB1 gene variants in Chinese Han population

Zhu

Chen

et al. 2017

Oncotarget

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“… 12 , 13 , 14 Additionally, the TOAST classification scheme has low interobserver reliability for CS, assigns more strokes as CSs than other classification schemes, and does not optimally describe the overlap between stroke mechanisms in individual patients. 12 , 15 , 16 , 17 Furthermore, some clinicians may be hesitant to assign a etiologic subtype, particularly if the stroke evaluation is incomplete at the time of hospital discharge. All of these issues may be barriers to the accurate documentation and reporting of etiologic stroke subtype in GWTG, contributing to the low overall rate of etiologic subtype reporting and the observed variability across hospitals.…”

Section: Discussionmentioning

confidence: 99%

Hospital‐Level Variability in Reporting of Ischemic Stroke Subtypes and Supporting Diagnostic Evaluation in GWTG‐Stroke Registry

Mullen,

Gurol,

Prabhakaran

et al. 2023

JAHA

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Background Secondary prevention of ischemic stroke (IS) requires adequate diagnostic evaluation to identify the likely etiologic subtype. We describe hospital‐level variability in diagnostic testing and IS subtyping in a large nationwide registry. Methods and Results We used the GWTG‐Stroke (Get With The Guidelines–Stroke) registry to identify patients hospitalized with a diagnosis of acute IS at 1906 hospitals between January 1, 2016, and September 30, 2017. We compared the documentation rates and presence of risk factors, diagnostic testing, achievement/quality measures, and outcomes between patients with and without reported IS subtype. Recording of diagnostic evaluation was optional in all IS subtypes except cryptogenic, where it was required. Of 607 563 patients with IS, etiologic IS subtype was documented in 57.4% and missing in 42.6%. Both the rate of missing stroke pathogenesis and the proportion of cryptogenic strokes were highly variable across hospitals. Patients missing stroke pathogenesis less frequently had documentation of risk factors, evidence‐based interventions, or discharge to home. The reported rates of major diagnostic testing, including echocardiography, carotid and intracranial vascular imaging, and short‐term cardiac monitoring were <50% in patients with documented IS pathogenesis, although these variables were missing in >40% of patients. Long‐term cardiac rhythm monitoring was rarely reported, even in cryptogenic stroke. Conclusions Reporting of IS etiologic subtype and supporting diagnostic testing was low overall, with high rates of missing optional data. Improvement in the capture of these data elements is needed to identify opportunities for quality improvement in the diagnostic evaluation and secondary prevention of stroke.

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“…Based on the clinical data, the patients were classi ed by the standard of Trial of org10172 in Acute Stroke Treatment (TOAST) [11]. The concepts used in this classi cation are mainly derived from the Harvard stroke registration classi cation and the National Institute of Neurological Diseases and Stroke Database of the United States [11][12][13]. According to the criteria, the patients included in this study were mainly divided into the following types: small-artery occlusion (SAO), large-artery atherosclerosis (LAA) and cardioembolism (CE).…”

Section: Toast Classi Cationmentioning

confidence: 99%

Correlation between the imaging manifestations of cerebellar infarction and the clinical characteristics of patients: a retrospective analysis

Wei¹,

Zhang²,

Meng³

et al. 2021

Preprint

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Background The aim of this study was to analyze the correlation between the imaging manifestations of cerebellar infarction and the clinical characteristics of patients. Methods A total of 83 patients with acute cerebellar infarction were included in this analysis. The NIHSS score, TOAST classification, CT and MRI examinations and serum laboratory tests were performed. The statistics of the data were carried out through descriptive statistics, T test and analysis of variance. Results Hyperlipidemia (66.3%), hypertension (77.1%) and carotid atherosclerosis (97.6%) were the main underlying causes of cerebellar infarction. Ataxia (67.5%) and brainstem syndrome (60.2%) were main clinical manifestations. Patients with NIHSS score ≤ 5 accounted for the majority (87.9%) and SAO (43.3%) and LAA (50.6%) were the main TOAST classifications. The cerebellar infarction caused by obstruction of SCA accounted for the majority (69.9%) and there was no statistical difference in the detection ability of CTA and MRA (P > 0.05). The incidence of left hemisphere cerebellar infarction was the highest (56.7%) and MRI showed an absolute advantage in showing the area of cerebellar infarction compared with CT (P < 0.001). The serum concentrations of D-dimer, LDL, and triglycerides were higher in patients with high NIHSS scores than in those with low scores (P < 0.05), while the serum HDL levels were just the opposite (P < 0.05). The serum D-dimer concentrations in patients classified as CE by TOAST were higher than that in patients classified as LAA and SAO (P < 0.05), while the serum concentrations of LDL were just the opposite (P < 0.05). The lesion sizes of cerebellar infarction were negatively related to the patient's serum HDL concentrations (P < 0.05) but it positively correlated with the NIHSS scores (P < 0.05). The patients classified as LAA had larger lesion sizes of cerebellar infarction than those classified as SAO and CE (P < 0.001). Conclusions CTA and MRA are comparable in showing the stenosis and obstruction of the cerebellar artery. However, MRI has an absolute advantage in showing the area of cerebellar infarction. The serum concentrations of D-dimer, HDL, LDL, and triglycerides are correlated with the patient’s NIHSS scores, TOAST classification and infarct sizes, which are helpful in evaluating the condition of the disease.

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Comparison of the Chinese ischemic stroke subclassification and Trial of Org 10172 in acute stroke treatment systems in minor stroke

Cited by 8 publications

References 29 publications

Genetic predisposition to ischaemic stroke by RAGE and HMGB1 gene variants in Chinese Han population

Genetic predisposition to ischaemic stroke by RAGE and HMGB1 gene variants in Chinese Han population

Hospital‐Level Variability in Reporting of Ischemic Stroke Subtypes and Supporting Diagnostic Evaluation in GWTG‐Stroke Registry

Correlation between the imaging manifestations of cerebellar infarction and the clinical characteristics of patients: a retrospective analysis

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