Lange Marcos C, Ribas Gustavo, Scavasine Valeria, Ducci Renata Dal-Prá, Mendes Danielle C, Zétola Viviane de Hiroki Flumignan, Cabral Norberto, Rundek Tatjana
Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Neurologia, Curitiba PR, Brasil.
Universidade da Região de Joinville, Departamento de Medicina, Joinville SC, Brasil.
Arq Neuropsiquiatr. 2018 Oct;76(10):649-653. doi: 10.1590/0004-282X20180095.
The aim of the study was to analyze the long-term recurrence rate in patients with a first-ever ischemic stroke secondary to intracranial large artery atherosclerosis (LAA) in a Brazilian population.
All stroke patients admitted to the hospital between October 2012 and September 2015 were evaluated. The stroke mechanism subtypes were classified as cardioembolism, LAA, small-vessel occlusion, other determined etiologies, and stroke of undetermined etiology.
The 359 first-ever ischemic stroke patients were followed up for a mean time of 21.6 ± 15.1 months. The LAA intracranial (38.9%) and extracranial (24.6%) stroke patients presented with a higher stroke recurrence. Intracranial LAA [HR, 10.2 (3.6-29.1); p < 0.001] and extracranial LAA [HR, 5.05 (1.79-14.2); p = 0.002] were the only conditions to show positive correlation with the recurrence rate, after adjusting for risk factors, thrombolysis, and National Institutes of Health Stroke Scale score at admission.
Intracranial LAA presents a higher incidence of recurrence of ischemic stroke when compared with other etiologies in a Southern Brazilian population.
本研究的目的是分析巴西人群中首次发生的继发于颅内大动脉粥样硬化（LAA）的缺血性卒中患者的长期复发率。
对2012年10月至2015年9月期间入院的所有卒中患者进行评估。卒中机制亚型分为心源性栓塞、LAA、小血管闭塞、其他确定病因和病因不明的卒中。
359例首次发生缺血性卒中的患者平均随访21.6±15.1个月。颅内LAA（38.9%）和颅外LAA（24.6%）卒中患者的卒中复发率较高。在调整了危险因素、溶栓治疗和入院时的美国国立卫生研究院卒中量表评分后，颅内LAA[风险比（HR），10.2（3.6 - 29.1）；p < 0.001]和颅外LAA[HR，5.05（1.79 - 14.2）；p = 0.002]是仅有的与复发率呈正相关的情况。
在巴西南部人群中，与其他病因相比，颅内LAA导致的缺血性卒中复发率更高。
