Nakamura Hikaru, Sato Kei, Hirayama Kosuke, Hayashi Yukishige, Tokunaga Yoshiharu
Neurosurgery, Nagasaki Prefecture Shimabara Hospital, Shimabara, JPN.
Cureus. 2022 Mar 28;14(3):e23591. doi: 10.7759/cureus.23591. eCollection 2022 Mar.
Background and purpose Internal carotid artery intima-media thickness (IMT) and pulse wave velocity (PWV) are risk factors of cerebrovascular disease and coronary artery disease. They are known as independent predictors of arteriosclerotic disease. It has been reported that IMT and PWV are useful factors for predicting stroke subtype and/or outcome. Coronary artery disease onset is proportional to atherosclerosis progression, and the Framingham Risk Score (FRS) and Suita score (SS) are standard risk predictors. This study examined whether FRS and SS can be useful for patient outcomes with acute infarction in the lenticulostriate artery (LSA) region without special tests or invasive procedures while using IMT or PWV as predictive factors. Methods We screened 629 consecutive patients with ischemic stroke and reviewed 84 patients with acute infarction in the LSA region who were admitted between January 2018 and December 2020. An early deterioration (ED) group was defined. In addition, the clinical characteristics, FRS, SS, treatment therapy, and neurovascular findings were evaluated. Results FRS and SS (FRS: 11.6 vs. 8.3, < 0.01, SS: 58.2 vs. 53.7, = 0.01, respectively), pre-symptomatic modified Rankin Scale (mRS) (p = 0.03), mRS at discharge (p < 0.01), and deterioration of manual muscle test (MMT) (<0.01) were significantly higher in patients in the ED (34 patients) group than in the no-ED group (54 patients). FRS and SS were correlated with mRS deterioration (FRS: r = 0.47;< 0.01, SS: r = 0.23; = 0.03). Among the laboratory parameters, total cholesterol (TC) (p < 0.01) and low-density lipoprotein cholesterol (LDL-C) (p < 0.01) were significantly higher in the ED group, and no significant differences in any acute therapeutic interventions. Conclusion Atherosclerosis risk scores, such as FRS and SS, may be useful for predicting outcomes in patients with acute LSA-region infarctions within 48 hours of onset.
颈内动脉内膜中层厚度（IMT）和脉搏波速度（PWV）是脑血管疾病和冠状动脉疾病的危险因素。它们被认为是动脉粥样硬化疾病的独立预测指标。据报道，IMT和PWV是预测卒中亚型和/或预后的有用因素。冠状动脉疾病的发病与动脉粥样硬化进展成正比，弗雷明汉风险评分（FRS）和吹田评分（SS）是标准的风险预测指标。本研究在将IMT或PWV作为预测因素的情况下，探讨了在不进行特殊检查或侵入性操作的情况下，FRS和SS是否对豆纹动脉（LSA）区域急性梗死患者的预后有用。方法：我们筛选了629例连续的缺血性卒中患者，并回顾了2018年1月至2020年12月期间收治的84例LSA区域急性梗死患者。定义了早期恶化（ED）组。此外，对临床特征、FRS、SS、治疗方法和神经血管检查结果进行了评估。结果：ED组（34例患者）的FRS和SS（FRS：11.6对8.3，<0.01；SS：58.2对53.7，=0.01）、症状前改良Rankin量表（mRS）（p = 0.03）、出院时mRS（p < 0.01）和徒手肌力测试（MMT）恶化（<0.01）显著高于非ED组（54例患者）。FRS和SS与mRS恶化相关（FRS：r = 0.47；<0.01；SS：r = 0.23；= 0.03）。在实验室参数中，ED组的总胆固醇（TC）（p < 0.01）和低密度脂蛋白胆固醇（LDL-C）（p < 0.01）显著更高，在任何急性治疗干预方面无显著差异。结论：FRS和SS等动脉粥样硬化风险评分可能有助于预测发病48小时内LSA区域急性梗死患者的预后。
