Al-Khaled Mohamed, Scheef Björn
a Department of Neurology , University of Lübeck , Lübeck , Germany.
Int J Neurosci. 2016 Oct;126(10):888-92. doi: 10.3109/00207454.2015.1077834. Epub 2015 Aug 24.
Symptomatic carotid stenosis (sCS), a common cause of transient ischemic attack (TIA), is correlated with higher stroke risk. We investigated the frequency and associated factors of sCS in patients with TIA and the association between sCS and stroke risk following TIA.
Over a three-year period (2011-2013), 861 consecutive patients with TIA, who were admitted to the Department of Neurology at the University of Lübeck, Germany, were included in a monocenter study and prospectively evaluated. Diagnosis of TIA was in accordance with the tissue-based definition (transient neurological symptoms without evidence of infarction by brain imaging).
Of 827 patients (mean age, 70 ± 13.2 years; 49.7% women), 64 patients (7.7%; 95% confidence interval [CI], 5.9%-9.7%) exhibited sCS and 3 patients (0.3%) showed an occlusion of the corresponding internal carotid artery. Logistic regression revealed that sCS was associated with male sex (odds ratio [OR], 2.7; 95% CI, 1.2-3.6; p = 0.012), amaurosis fugax (OR, 8.1; 95% CI, 3.4-19-4; p < 0.001), unilateral weakness (OR, 3.4; 95% CI, 1.9-6.1; p < 0.001), symptom duration less than 1 h (OR, 2.0; 95% CI, 1.1-3.4; p = 0.019) and previous stroke (OR, 2.7; 95% CI, 1.5-4.7; p = 0.001). During hospitalization (mean, 6.6 days), five patients (0.6%; 95% CI, 0.1%-1.2%) suffered from stroke. The stroke risk was higher in patients with sCS than in those without sCS (6.3% vs. 0.1%; p < 0.001), whereas the recurrent TIA risk (2.6%) did not differ between the groups (4.7% vs. 2.5%; p = 0.29).
SCS appears to be associated with a higher risk of stroke in patients with TIA defined according to the tissue-based definition.
症状性颈动脉狭窄（sCS）是短暂性脑缺血发作（TIA）的常见病因，与较高的卒中风险相关。我们调查了TIA患者中sCS的发生率及相关因素，以及sCS与TIA后卒中风险之间的关联。
在三年期间（2011 - 2013年），德国吕贝克大学神经病学系收治的861例连续TIA患者纳入一项单中心研究并进行前瞻性评估。TIA的诊断依据基于组织的定义（短暂性神经症状，脑成像无梗死证据）。
827例患者（平均年龄70±13.2岁；49.7%为女性）中，64例（7.7%；95%置信区间[CI]，5.9% - 9.7%）表现为sCS，3例（0.3%）显示相应颈内动脉闭塞。逻辑回归显示，sCS与男性（优势比[OR]，2.7；95%CI，1.2 - 3.6；p = 0.012）、一过性黑矇（OR，8.1；95%CI，3.4 - 19.4；p < 0.001）、单侧无力（OR，3.4；95%CI，1.9 - 6.1；p < 0.001）、症状持续时间小于1小时（OR，2.0；95%CI，1.1 - 3.4；p = 0.019）及既往卒中（OR，2.7；95%CI，1.5 - 4.7；p = 0.001）相关。住院期间（平均6.6天），5例患者（0.6%；95%CI，0.1% - 1.2%）发生卒中。sCS患者的卒中风险高于无sCS患者（6.3%对0.1%；p < 0.001），而两组间复发性TIA风险（2.6%）无差异（4.7%对2.5%；p = 0.29）。
根据基于组织的定义，sCS似乎与TIA患者较高的卒中风险相关。
