颅前动脉钙化负担：急性大动脉闭塞患者再灌注临床结局的潜在指标。
Precranial artery calcification burden: a potential indicator of the clinical outcome of reperfusion in patients with acute large artery occlusion.
机构信息
Centre for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
Key Laboratory of Bioorganic Synthesis of Zhejiang Province, College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, Zhejiang, China.
出版信息
J Int Med Res. 2024 Jul;52(7):3000605241260364. doi: 10.1177/03000605241260364.
OBJECTIVE
With mechanical thrombectomy (MT), we investigated the prognostic importance of aortic arch calcification (AoAC) and carotid sinus calcification (CaSC) for symptomatic intracerebral hemorrhage (sICH) and poor outcome in acute large artery occlusion (LAO).
METHODS
In this retrospective observational study, we calculated pre-cranial artery calcification burden (PACB) scores (burden score of AoAC and CaSC) using the AoAC grading scale score plus Woodcock visual score. The outcome measure was sICH per the European Cooperative Acute Stroke Study III definition. A 3-month modified Rankin scale score 3-6 was designated as poor outcome.
RESULTS
Compared with patients who had PACB <3, those with PACB ≥3 showed substantially higher risks of sICH (odds ratio [OR] = 2.567, 95% confidence interval [CI] = 1.187-5.550) and poor outcome (OR = 4.777, 95% CI = 1.659-13.756). According to receiver operating characteristic (ROC) curves, adding PACB to the regression model enhanced the predictive value for poor outcome (area under the ROC curve [AUC]: 0.718 vs. 0.519, Z = 2.340) and in patients receiving MT (AUC: 0.714 vs. 0.584, Z = 2.021), independently.
CONCLUSIONS
Factors related to PACB were consistent with common risk factors of systemic atherosclerosis. Low PACB scores indicated better prognosis. In patients with LAO following MT, PACB was useful in predicting sICH and poor clinical outcome.
目的
采用机械取栓（MT）治疗，我们研究了主动脉弓钙化（AoAC）和颈动脉窦钙化（CaSC）对症状性颅内出血（sICH）和急性大动脉闭塞（LAO）不良预后的预测价值。
方法
在这项回顾性观察研究中，我们使用 AoAC 分级量表评分加 Woodcock 视觉评分计算颅前动脉钙化负担（PACB）评分（AoAC 和 CaSC 的负担评分）。结局测量指标是欧洲合作急性卒中研究 III 定义的 sICH。3 个月时改良 Rankin 量表评分 3-6 定义为不良预后。
结果
与 PACB<3 的患者相比，PACB≥3 的患者 sICH 风险显著增加（比值比 [OR] = 2.567，95%置信区间 [CI] = 1.187-5.550）和不良预后的风险（OR = 4.777，95% CI = 1.659-13.756）。根据受试者工作特征（ROC）曲线，将 PACB 添加到回归模型中提高了不良预后的预测价值（ROC 曲线下面积 [AUC]：0.718 与 0.519，Z = 2.340），以及在接受 MT 治疗的患者中（AUC：0.714 与 0.584，Z = 2.021）。
结论
与 PACB 相关的因素与全身性动脉粥样硬化的常见危险因素一致。低 PACB 评分表明预后较好。在接受 MT 治疗的 LAO 患者中，PACB 有助于预测 sICH 和不良临床结局。
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