Ischemic stroke in patients with intermittent claudication: a clinical study of 142 cases

Abstract

Abstract:The clinical features, risk factors, neuroimaging ndings, and outcome of acute ischemic stroke were assessed in patients with intermittent claudication. Data from 142 patients with ischemic stroke and intermittent claudication were collected from a prospective hospitalbased stroke registry in which 2500 consecutive acute stroke patients attended over a 12-year period. Ischemic stroke in patients with intermittent claudication accounted for 7.7% of all ischemic strokes (nˆ1840). Ischemic stroke with and without intermittent claudication showed a similar in-hospital mortality rate (16% vs 14%) and absence of functional limitation at hospital discharge (20.5% vs 18.5%). Ischemic stroke patients with intermittent claudication showed a signi cantly shorter length of stay than patients without symptomatic peripheral arterial disease (14.6 vs 18.8 days, p < 0.05). Ischemic heart disease, transient ischemic attack (TIA), renal dysfunction, and watershed infarct were signi cant independent predictors of ischemic stroke in patients with intermittent claudication. Although cerebral infarction in patients with intermittent claudication showed a clinical pro le suggestive of poor outcome, the prognosis was similar to that of ischemic stroke without intermittent claudication.

Infarctions in the vascular territory of the posterior cerebral artery: clinical features in 232 patients

“…Details of this on-going hospital-based stroke registry have been previously reported [4]. Classification of subtypes of stroke and definitions of vascular risk factors were those recommended by the Cerebrovascular Study Group of the Spanish Society of Neurology [5] and have been used in previous studies [4,6,7]. …”

“…The region of the infarction was identified on computerized tomographic (CT) scans and/or magnetic resonance imaging (MRI) studies and then PCA ( n = 232), ACA ( n = 51) and MCA ( n = 1355) topographies were chosen. These three vascular territories were defined according to previously published and validated maps of cerebral vascular territories [8] and used in other studies [4,6,7,9]. Cortical, deep (involving thalamus and/or midbrain), or cortical and deep distribution in PCA topography were recorded.…”

Importancia del perfil cardiovascular en la mortalidad hospitalaria de los infartos cerebrales

“…Sin embargo, hay que señalar que en nuestro estudio cada subtipo etiológico de infarto cerebral presenta un perfil cardiovascular propio, característico y diferenciado. En los aterotrombóticos se objetiva un perfil de factores de riesgo en el cual sobresale la presencia de la enfermedad vascular periférica (OR = 2,28), que constituye un indicador evidente y conocido de aterosclerosis generalizada 21 , junto con la HTA (OR = 1,84) y la diabetes mellitus (OR = 1,66), que son los principales factores de riesgo clásicamente relacionados con la morbilidad cardiovascular y cerebrovascular de las arterias de gran calibre 18,19 . Otros factores de riesgo son haber tenido un AIT (OR = 1,50) -que constituye una verdadera urgencia neurológica por su riesgo precoz de isquemia cerebral definitiva ulterior 4,9 -, tener EPOC (OR = 1,40) -entidad relacionada con el tabaquismo y con infecciones bronquiales de repetición que pueden ocasionar un estado subclínico de hipercoagubilidad adquirida 5,22 -, el infarto cerebral previo (OR = 1,40) -que constituye por sí mismo un factor de riesgo conocido de nuevos infarto cerebral 5 -y la cardiopatía isquémica (OR = 1,33) -que es tanto un epifenómeno de la arteriosclerosis clínicamente definida como una causa potencial de infarto cerebral de repetición 1,4 -.…”

“…Finalmente, en los infartos indeterminados solamente la HTA (OR = 3,68) y la edad se mostraron TABLA 6. Análisis comparativo de las características demográficas, la estancia y la mortalidad hospitalaria de los infartos cerebrales en tres períodos de estudio 13 [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] 13 [9][10][11][12][13][14][15][16][17][18][19][20][21][22] 11 [8][9][10][11][12][13][14][15][16][17][18] < 0,001 Mortalidad hospitalaria 140 (15) 121 (13,5) 89 (10,2) 0,009 como factores de riesgo independientemente asociados a la mortalidad hospitalaria. Es muy importante destacar los aspectos evolutivos pronósticos y asistenciales observados en nuestro estudio, con una disminución progresiva en la mortalidad hospitalaria (el 15 frente al 13,5 frente al 10,2%; p < 0,001) y en la mediana de estancia hospitalaria (13 días frente a 11 días; p = 0,009).…”

Nineteen-Year Trends in Risk Factors, Clinical Characteristics and Prognosis in Lacunar Infarcts

“…Patients are chosen for admission to the Department of Neurology if the reason for consultation is an acute cerebrovascular event occurring independently of the presence or absence of severe concomitant medical problems. Details of variables, including cerebrovascular risk factors prospectively registered in the database, have been reported in previous studies [4,5] . Subtypes of stroke including primary intracerebral hemorrhage and ischemic infarction (i.e.…”