TY - JOUR
T1 - Different Characteristics of Anterior and Posterior Branch Atheromatous Diseases with or without Early Neurologic Deterioration
AU - Takahashi, Yoshiaki
AU - Yamashita, Toru
AU - Morihara, Ryuta
AU - Nakano, Yumiko
AU - Sato, Kota
AU - Takemoto, Mami
AU - Hishikawa, Nozomi
AU - Ohta, Yasuyuki
AU - Manabe, Yasuhiro
AU - Abe, Koji
N1 - Funding Information:
We appreciate the cooperation of all patients. This work was partly supported by Grants-in-Aid for Scientific Research (B) 25293202, (C) 15K15527, and Young Research 15K21181, and by Grants-in-Aid from the Research Committees (Mizusawa H, Nakashima K, Nishizawa M, Sasaki H, and Aoki M) from the Ministry of Health, Labour and Welfare of Japan.
Publisher Copyright:
© 2017 National Stroke Association
PY - 2017/6
Y1 - 2017/6
N2 - Background Among several types of ischemic stroke (IS), branch atheromatous disease (BAD) is known to be the leading cause of disability. Methods A total of 1919 patients with acute IS were retrospectively analyzed, and BAD patients were classified into anterior or posterior BAD, depending on the responsible vascular territories. These patients were further subcategorized with or without early neurologic deterioration (END or no-END). Results Of all IS patients, 14.3% had BAD, and 202 patients (73.7%) were further classified as anterior BAD and 72 patients (26.3%) as posterior BAD. The prevalence of diabetes mellitus and END was significantly higher in posterior than in anterior BAD (44.4% vs 26.4%, P < .01; 18.1% vs 5.4%, P < .01, respectively). Posterior BAD showed a higher proportion of female patients and an older age (69.2% vs 39.0%, P < .05; 79.1 ± 7.7 vs 70.5 ± 10.7, P < .01, respectively) in END than in no-END. The modified Rankin Scale was worse in posterior BAD at 90 days (2.5 ± 1.6, P < .01) than in anterior BAD (1.6 ± 1.4). Conclusions Our present study shows that posterior BAD is a worse clinical outcome than anterior BAD, with more vascular risk factors. Older female patients with posterior BAD showed a higher risk of END, leading to a worse clinical outcome.
AB - Background Among several types of ischemic stroke (IS), branch atheromatous disease (BAD) is known to be the leading cause of disability. Methods A total of 1919 patients with acute IS were retrospectively analyzed, and BAD patients were classified into anterior or posterior BAD, depending on the responsible vascular territories. These patients were further subcategorized with or without early neurologic deterioration (END or no-END). Results Of all IS patients, 14.3% had BAD, and 202 patients (73.7%) were further classified as anterior BAD and 72 patients (26.3%) as posterior BAD. The prevalence of diabetes mellitus and END was significantly higher in posterior than in anterior BAD (44.4% vs 26.4%, P < .01; 18.1% vs 5.4%, P < .01, respectively). Posterior BAD showed a higher proportion of female patients and an older age (69.2% vs 39.0%, P < .05; 79.1 ± 7.7 vs 70.5 ± 10.7, P < .01, respectively) in END than in no-END. The modified Rankin Scale was worse in posterior BAD at 90 days (2.5 ± 1.6, P < .01) than in anterior BAD (1.6 ± 1.4). Conclusions Our present study shows that posterior BAD is a worse clinical outcome than anterior BAD, with more vascular risk factors. Older female patients with posterior BAD showed a higher risk of END, leading to a worse clinical outcome.
KW - Branch atheromatous disease
KW - acute ischemic stroke
KW - anterior circulation
KW - early neurologic deterioration
KW - posterior circulation
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U2 - 10.1016/j.jstrokecerebrovasdis.2017.02.001
DO - 10.1016/j.jstrokecerebrovasdis.2017.02.001
M3 - Article
C2 - 28365073
AN - SCOPUS:85016648796
VL - 26
SP - 1314
EP - 1320
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
SN - 1052-3057
IS - 6
ER -
