Peycheva Marieta, Padlina Giovanna, Genceviciute Kotryna, Krasteva Marina P, Boronylo Anna, Goeldlin Martina B, Müller Madlaine, Wenz Elena S, Müller Mandy D, Hammer Helly, Bücke Philipp, Bigi Sandra, Simonetti Barbara Goeggel, Hoffmann Angelika, Umarova Roza M, Pilgram-Pastor Sara, Gralla Jan, Mordasini Pasquale, Antonenko Kateryna, Heldner Mirjam R
Department of Neurology, Inselspital, University Hospital and University of Bern, Bern, Switzerland.
Department of Neurology and Research Institute, Medical University Plovdiv, Plovdiv, Bulgaria.
Front Neurol. 2024 Apr 17;15:1293905. doi: 10.3389/fneur.2024.1293905. eCollection 2024.
The aim of this study was to investigate baseline characteristics and outcome of patients after endovascular therapy (EVT) for acute large vessel occlusion (LVO) in relation to their history of symptomatic vascular disease and sex.
Consecutive EVT-eligible patients with LVO in the anterior circulation admitted to our stroke center between 04/2015 and 04/2020 were included in this observational cohort study. All patients were treated according to a standardized acute ischaemic stroke (AIS) protocol. Baseline characteristics and successful reperfusion, recurrent/progressive in-hospital ischaemic stroke, symptomatic in-hospital intracranial hemorrhage, death at discharge and at 3 months, and functional outcome at 3 months were analyzed according to previous symptomatic vascular disease and sex.
995 patients with LVO in the anterior circulation (49.4% women, median age 76 years, median admission NIHSS score 14) were included. Patients with multiple vs. no previous vascular events showed higher mortality at discharge (20% vs. 9.3%, OR = 1.43, = 0.030) and less independency at 3 months (28.8% vs. 48.8%, OR = 0.72, = 0.020). All patients and men alone with one or multiple vs. patients and men with no previous vascular events showed more recurrent/progressive in-hospital ischaemic strokes (19.9% vs. 6.4% in all patients, OR = 1.76, = 0.028) (16.7% vs. 5.8% in men, age-adjustedOR = 2.20, = 0.035). Men vs. women showed more in-hospital symptomatic intracranial hemorrhage among patients with one or multiple vs. no previous vascular events (23.7% vs. 6.6% in men and 15.4% vs. 5.5% in women, OR = 2.32, = 0.035/OR = 2.36, = 0.035).
Previous vascular events increased the risk of in-hospital complications and poorer outcome in the analyzed patients with EVT-eligible LVO-AIS. Our findings may support risk assessment in these stroke patients and could contribute to the design of future studies.
本研究旨在调查急性大血管闭塞（LVO）患者接受血管内治疗（EVT）后的基线特征及预后，以及其症状性血管疾病史和性别的关系。
本观察性队列研究纳入了2015年4月至2020年4月间收入我院卒中中心、符合EVT治疗标准的前循环LVO连续患者。所有患者均按照标准化急性缺血性卒中（AIS）方案进行治疗。根据既往症状性血管疾病和性别分析基线特征、成功再灌注情况、住院期间复发性/进展性缺血性卒中、症状性颅内出血、出院时及3个月时的死亡情况，以及3个月时的功能预后。
纳入995例前循环LVO患者（女性占49.4%，中位年龄76岁，入院时NIHSS评分中位数为14）。有多次与无既往血管事件的患者出院时死亡率更高（20% vs. 9.3%，OR = 1.43，P = 0.030），3个月时独立性更低（28.8% vs. 48.8%，OR = 0.72，P = 0.020）。所有患者及仅男性患者中，有一次或多次既往血管事件与无既往血管事件的患者相比，住院期间复发性/进展性缺血性卒中更多（所有患者中19.9% vs. 6.4%，OR = 1.76，P = 0.028）（男性中16.7% vs. 5.8%，年龄校正OR = 2.20，P = 0.035）。有一次或多次与无既往血管事件的患者中，男性与女性相比，住院期间症状性颅内出血更多（男性中23.7% vs. 6.6%，女性中15.4% vs. 5.5%，OR = 2.32，P = 0.035/OR = 2.36，P = 0.035）。
既往血管事件增加了符合EVT治疗标准的LVO - AIS分析患者住院并发症风险及不良预后。我们的研究结果可能有助于这些卒中患者的风险评估，并可能为未来研究的设计做出贡献。
