Predictors of positive remodeling in patients with acute ischemia stroke

Abstract

ObjectiveThis study aimed to delineate the differences in plaques characteristics between positive remodeling (PR) and non-positive remodeling (NPR) in patients with Acute ischemia stroke (AIS), and to assess the associated relative risk factors for PR in intracranial atherosclerosis (ICAS).MethodsPatients with AIS were enrolled and underwent high-resolution magnetic resonance vessel wall imaging (HR-VWI) within two weeks of symptom onset. We compared plaque morphologies and clinical variables between the PR and NPR cohorts. Binary logistic regression was employed to isolate independent predictors of PR, and the predictive model’s sensitivity and specificity were gauged using the receiver operating characteristic curve.ResultsA total of 84 patients (mean age 58.07±1.35 years, 78.6% male) were categorized into PR (n=28, 33.3%) or NPR (n=56, 66.4%) groups based on the remodeling index (RI). The PR group exhibited a significantly higher percent plaque burden (P<0.001), wall area (WA) (P<0.001), plaque length (P=0.018), and RI (P<0.001), alongside elevated fasting blood glucose (P=0.01) and a higher prevalence of hypertension and diabetes mellitus (P=0.16, 0.025). Logistic regression analysis identified percent plaque burden as an independent predictor of PR (odds ratio, 4.19, per 10% increase; [95% CI, 1.79-9.8];P=0.001).ConclusionHR-VWI is an effective tool for identifying PR in AIS caused by ICAS, with a high plaque burden being an independent correlate of PR.