Long-term prognosis of symptomatic isolated middle cerebral artery disease in Korean stroke patients

Abstract

BackgroundThis study aimed to investigate the long-term mortality and recurrence rate of stroke in first-time stroke patients with symptomatic isolated middle cerebral artery disease (MCAD) under medical management.MethodsWe identified 141 first ever stroke patients (mean age, 64.4 ± 12.5 years; 53% male) with symptomatic isolated MCAD. MCAD was defined as significant stenosis of more than 50% or occlusion of the MCA as revealed by MR angiography. The median follow-up was 27.7 months. We determined a cumulative rate of stroke recurrence and mortality by Kaplan-Meier survival analyses and sought predictors using the Cox proportional hazard model.ResultsThe cumulative composite outcome rate (stroke recurrence or any-cause death) was 14%, 19%, 22%, and 28% at years 1, 2, 3, and 5, respectively. The annual recurrence rate of stroke was 4.1%. The presence of diabetes mellitus was the only significant independent predictor of stroke recurrence or any cause of death in multivariate analyses of Cox proportional hazard model adjusted for any plausible potential confounding factors.ConclusionsWe estimated the long-term prognosis of stroke patients with isolated symptomatic MCAD under current medical management in Korea. Diabetes mellitus was found to be a significant predictor for stroke recurrence and mortality.

Remote limb ischemic conditioning treatment for intracranial atherosclerotic stenosis patients

“…Symptomatic intracranial atherosclerotic stenosis (ICAS) is a significant independent predictor of stroke recurrence and mortality in Asian patients. 1 In China, ICAS is responsible for 42%–50% of strokes, a rate that varies based on geographic location. 2 The high rate of stroke recurrence in ICAS patients has led to a search for novel approaches to reduce the risk of stroke.…”

Multiple intracranial arterial stenosis influences the long-term prognosis of symptomatic middle cerebral artery occlusion

“…Diabetes mellitus is a well-known risk factor for both small and large vessel diseases. Previous studies have identified diabetes mellitus as a risk factor for recurrent vascular events or death in patients with predominantly intracranial atherosclerosis [ 9 , 10 ]. We also identified the presence of diabetes mellitus as a potential independent potential predictor of the long-term outcome, stroke recurrence, or any-cause death.…”

“…Although the prognosis of patients with symptomatic and asymptomatic MCA stenosis has been studied previously, few studies have reported data on patients with a middle cerebral artery occlusion (MCAO). Furthermore, the previous studies have reported that the recurrence of stroke in patients with MCAO did not differ from stroke recurrence with severe MCA stenosis [ 5 , 6 , 8 , 9 ]. These studies included a very small number of patients.…”

“…Previous studies have reported that diabetes mellitus, stroke symptoms, and gender may influence the prognosis of patients with symptomatic MCAO [ 7 , 9 , 10 ]. However, there is little in the literature on MCAO with concomitant intracranial arterial disease (MCAO-AIS).…”

Inflammatory and metabolic markers and short-time outcome in patients with acute ischemic stroke in relation to TOAST subtypes

“…The short-time outcome was evaluated using the modified Rankin Scale (mRS) (Bonita and Beaglehole 1988) applied within the first eight hours of admission (baseline) and three-month followed up. The outcome was assessed by clinical examination or using telephone interviews with the patients or their relatives (Oh et al 2011). The patients were divided in two groups: mRS < 3 was graded as favorable outcome or independence (no symptoms/mild disability) and ≥ 3 was graded as unfavorable outcome or dependence (moderate/severe disability) (Abubakar et al 2013;Uyttenboogaart et al 2005).…”