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Thrombolysis Outcomes in Acute Ischemic Stroke by Fluid-Attenuated Inversion Recovery Hyperintense Arteries.
Zhou, Zien; Yoshimura, Sohei; Delcourt, Candice; Lindley, Richard I; You, Shoujiang; Malavera, Alejandra; Torii-Yoshimura, Takako; Carcel, Cheryl; Wang, Xia; Chen, Xiaoying; Parsons, Mark W; Demchuk, Andrew M; Wardlaw, Joanna M; Mair, Grant; Robinson, Thompson G; Chalmers, John; Xu, Jianrong; Anderson, Craig S.
Afiliação
  • Zhou Z; Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, China (Z.Z., J.X.).
  • Yoshimura S; The George Institute for Global Health, Faculty of Medicine, University of New South Wales Sydney, Australia (Z.Z., S.Y., C.D., A.M., T.T.-Y., C.C., X.W., X.C., J.C., C.S.A.).
  • Delcourt C; The George Institute for Global Health, Faculty of Medicine, University of New South Wales Sydney, Australia (Z.Z., S.Y., C.D., A.M., T.T.-Y., C.C., X.W., X.C., J.C., C.S.A.).
  • Lindley RI; The George Institute for Global Health, Faculty of Medicine, University of New South Wales Sydney, Australia (Z.Z., S.Y., C.D., A.M., T.T.-Y., C.C., X.W., X.C., J.C., C.S.A.).
  • You S; Department of Neurology, Royal Prince Alfred Hospital, Sydney Health Partners, Australia (C.D., C.C., C.S.A.).
  • Malavera A; Sydney Medical School, University of Sydney, Australia (C.D., C.C.).
  • Torii-Yoshimura T; The George Institute for Global Health and Westmead Applied Research Centre, University of Sydney, Australia (R.I.L.).
  • Carcel C; Department of Cerebrovascular Medicine (S.Y.), National Cerebral and Cardiovascular Center, Osaka, Japan.
  • Wang X; Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, China (S.Y.).
  • Chen X; The George Institute for Global Health, Faculty of Medicine, University of New South Wales Sydney, Australia (Z.Z., S.Y., C.D., A.M., T.T.-Y., C.C., X.W., X.C., J.C., C.S.A.).
  • Parsons MW; The George Institute for Global Health, Faculty of Medicine, University of New South Wales Sydney, Australia (Z.Z., S.Y., C.D., A.M., T.T.-Y., C.C., X.W., X.C., J.C., C.S.A.).
  • Demchuk AM; Division of Neurology, Department of Stroke and Cerebrovascular Diseases (T.T.-Y.), National Cerebral and Cardiovascular Center, Osaka, Japan.
  • Wardlaw JM; Department of Neurology and Neuroscience, Nagoya City University Graduate School of Medical Science, Japan (T.T.-Y.).
  • Mair G; The George Institute for Global Health, Faculty of Medicine, University of New South Wales Sydney, Australia (Z.Z., S.Y., C.D., A.M., T.T.-Y., C.C., X.W., X.C., J.C., C.S.A.).
  • Robinson TG; Department of Neurology, Royal Prince Alfred Hospital, Sydney Health Partners, Australia (C.D., C.C., C.S.A.).
  • Chalmers J; Sydney Medical School, University of Sydney, Australia (C.D., C.C.).
  • Xu J; The George Institute for Global Health, Faculty of Medicine, University of New South Wales Sydney, Australia (Z.Z., S.Y., C.D., A.M., T.T.-Y., C.C., X.W., X.C., J.C., C.S.A.).
  • Anderson CS; The George Institute for Global Health, Faculty of Medicine, University of New South Wales Sydney, Australia (Z.Z., S.Y., C.D., A.M., T.T.-Y., C.C., X.W., X.C., J.C., C.S.A.).
Stroke ; 51(7): 2240-2243, 2020 07.
Article em En | MEDLINE | ID: mdl-32568636
BACKGROUND AND PURPOSE: To determine factors associated with fluid-attenuated inversion recovery (FLAIR) hyperintense arteries (FLAIR-HAs) on magnetic resonance imaging and their prognostic significance in thrombolysis-treated patients with acute ischemic stroke from the ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study) trial alteplase-dose arm. METHODS: Patients with acute ischemic stroke (N=293) with brain magnetic resonance imaging (FLAIR and diffusion-weighted imaging sequences) scanned <4.5 hours of symptom onset were assessed for location and extent (score) of FLAIR-HAs, infarct volume, large vessel occlusion (LVO), and other ischemic signs. Logistic regression models were used to determine predictors of FLAIR-HAs and the association of FLAIR-HAs with 90-day outcomes: favorable functional outcome (primary; modified Rankin Scale scores, 0-1), other modified Rankin Scale scores, and intracerebral hemorrhage. RESULTS: Prior atrial fibrillation, LVO, large infarct volume, and anterior circulation infarction were independently associated with FLAIR-HAs. The rate of modified Rankin Scale scores 0 to 1 was numerically lower in patients with FLAIR-HAs versus without (69/152 [45.4%] versus 75/131 [57.3%]), as was the subset of LVO (37/93 [39.8%] versus 9/16 [56.3%]), but not in those without LVO (25/36 [69.4%] versus 60/106 [56.6%]). After adjustment for covariables, FLAIR-HAs were independently associated with increased primary outcome (adjusted odds ratio [95% CI]: overall 4.14 [1.63-10.50]; with LVO 4.92 [0.87-27.86]; no LVO 6.16 [1.57-24.14]) despite an increased risk of hemorrhagic infarct (4.77 [1.12-20.26]). CONCLUSIONS: FLAIR-HAs are more frequent in acute ischemic stroke with cardioembolic features and indicate potential for a favorable prognosis in thrombolysis-treated patients possibly mediated by LVO. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01422616.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artérias Cerebrais / Recuperação de Função Fisiológica / Acidente Vascular Cerebral Tipo de estudo: Prognostic_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Stroke Ano de publicação: 2020 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
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XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artérias Cerebrais / Recuperação de Função Fisiológica / Acidente Vascular Cerebral Tipo de estudo: Prognostic_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Stroke Ano de publicação: 2020 Tipo de documento: Article País de publicação: Estados Unidos