Bonacina Sonia, Grassi Mario, Zedde Marialuisa, Zini Andrea, Bersano Anna, Gandolfo Carlo, Silvestrelli Giorgio, Baracchini Claudio, Cerrato Paolo, Lodigiani Corrado, Marcheselli Simona, Paciaroni Maurizio, Rasura Maurizia, Cappellari Manuel, Del Sette Massimo, Cavallini Anna, Morotti Andrea, Micieli Giuseppe, Lotti Enrico Maria, DeLodovici Maria Luisa, Gentile Mauro, Magoni Mauro, Azzini Cristiano, Calloni Maria Vittoria, Giorli Elisa, Braga Massimiliano, La Spina Paolo, Melis Fabio, Tassi Rossana, Terruso Valeria, Calabrò Rocco Salvatore, Melis Maurizio, Sessa Maria, Locatelli Martina, Sanguigni Sandro, Zanferrari Carla, Mannino Marina, Calabrese Giuseppina, Dallocchio Carlo, Nencini Patrizia, Bignamini Valeria, Adami Alessandro, Magni Eugenio, Bella Rita, Padovani Alessandro, Pezzini Alessandro
Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy.
Dipartimento di Scienze del Sistema Nervoso e del Comportamento, Unità di Statistica Medica e Genomica, Università di Pavia, Pavia, Italy.
Neurol Sci. 2020 Nov;41(11):3265-3272. doi: 10.1007/s10072-020-04464-9. Epub 2020 May 12.
Long-term consequences of cervical artery dissection (CeAD), a major cause of ischemic stroke in young people, have been poorly investigated. The Italian Project on Stroke at Young Age - Cervical Artery Dissection (IPSYS CeAD) project is a multicenter, hospital-based, consecutively recruiting, observational, cohort study aimed to address clinically important questions about long-term outcome of CeAD patients, which are not covered by other large-scale registries. Patients with radiologically diagnosed CeAD were consecutively included in the registry. Baseline demographic and clinical variables, as well as information on risk factors, were systematically collected for each eligible patient. Follow-up evaluations were conducted between 3 and 6 months after the initial event (t) and then annually (t at 1 year, t at 2 years , and so on), in order to assess outcome events (long-term recurrent CeAD, any fatal/nonfatal ischemic stroke, transient ischemic attack (TIA), or other arterial thrombotic event, and death from any cause). Between 2000 and 2019, data from 1530 patients (age at diagnosis, 47.2 ± 11.5 years; women, 660 [43.1%]) have been collected at 39 Italian neurological centers. Dissection involved a single vessel in 1308 (85.5%) cases and caused brain ischemia in 1303 (85.1%) (190 TIA/1113 ischemic stroke). Longitudinal data are available for 1414 (92.4%) patients (median follow-up time in patients who did not experience recurrent events, 36.0 months [25th to 75th percentile, 63.0]). The collaborative IPSYS CeAD effort will provide novel information on the long-term outcome of CeAD patients. This could allow for tailored treatment approaches based on patients' individual characteristics.
作为年轻人缺血性中风的主要病因,颈动脉夹层(CeAD)的长期后果尚未得到充分研究。意大利青年卒中项目 - 颈动脉夹层(IPSYS CeAD)项目是一项多中心、基于医院、连续招募的观察性队列研究,旨在解决有关CeAD患者长期预后的临床重要问题,而其他大规模登记研究并未涵盖这些问题。经放射学诊断为CeAD的患者被连续纳入该登记研究。为每位符合条件的患者系统收集基线人口统计学和临床变量以及危险因素信息。在初始事件(t)后3至6个月进行随访评估,然后每年进行一次(1年时的t、2年时的t等),以评估结局事件(长期复发性CeAD、任何致命/非致命性缺血性中风、短暂性脑缺血发作(TIA)或其他动脉血栓形成事件以及任何原因导致的死亡)。2000年至2019年期间,意大利39个神经科中心收集了1530例患者的数据(诊断时年龄为47.2±11.5岁;女性660例[43.1%])。1308例(85.5%)病例的夹层累及单一血管,1303例(85.1%)导致脑缺血(190例TIA/1113例缺血性中风)。1414例(92.4%)患者有纵向数据(未发生复发事件患者的中位随访时间为36.0个月[第25至75百分位数为63.0])。IPSYS CeAD的合作努力将提供有关CeAD患者长期预后的新信息。这可以根据患者的个体特征制定个性化的治疗方法。