Associations between multiple acute infarctions and intracranial arterial stenosis with functional outcomes in anterior circulation acute ischaemic stroke reperfusion therapy: results from the China National Stroke Registry III.

OBJECTIVE

This study aims to observe the correlation between infarction pattern and intracranial arterial stenosis (ICAS) on magnetic resonance and functional outcome in acute ischaemic stroke (AIS) patients after reperfusion therapy.

DESIGN

This is a post hoc analysis of the Third China National Stroke Registry (CNSR-III) study.

SETTING

The data was derived from the CNSR-III study, which was a nationwide clinical registry of ischaemic stroke or transient ischaemic attack based in China.

PARTICIPANTS

Patients with anterior circulation AIS who underwent reperfusion therapy were included for analysis. The patients were divided into single acute infarction and multiple acute infarctions (MAIs) based on the diffusion-weighted imaging findings. Additionally, patients were categorised according to the degree of ICAS assessed by magnetic resonance angiography as either ≥50% or <50%.

PRIMARY OUTCOME MEASURES

The primary outcome of this study was poor functional outcome at 12 months, defined as a modified Rankin Scale of 3-6.

RESULTS

In the included 796 patients, there were 152, 130 and 126 cases of unfavourable functional outcomes at 3 months, 6 months and 12 months, respectively. After adjusting for all potential confounding factors, MAIs were significantly associated with an increased risk of poor functional outcomes at 12 months (OR 1.96; 95% CI 1.27 to 3.02; p=0.0024). Similarly, ≥50% ICAS was also correlated with an increased risk of poor functional outcomes (OR 1.74; 95% CI 1.14 to 2.67; p=0.0110).

CONCLUSIONS

Both MAIs and ≥50% ICAS were associated with poor functional outcomes in patients with anterior circulation AIS who received reperfusion therapy.