The correlation between intracranial arterial calcification and the outcome of reperfusion therapy

Author:

Du Heng1ORCID,Zheng Jianrong2,Li Xuelong1,Bos Daniel34,Yang Wenjie5ORCID,Cheng Yajing2,Liu Cong2,Wong Lawrence Ka Sing6,Hu Jun2,Chen Xiangyan1

Affiliation:

1. Department of Health Technology and Informatics The Hong Kong Polytechnic University Kowloon Hong Kong SAR China

2. Department of Neurology Peking University Shenzhen Hospital Shenzhen China

3. Department of Radiology and Nuclear Medicine, Department of Epidemiology Erasmus MC University Medical Center Rotterdam Netherlands

4. Department of Clinical Epidemiology Harvard TH Chan School of Public Health Boston Massachusetts USA

5. Department of Diagnostic Radiology and Nuclear Medicine University of Maryland School of Medicine Baltimore USA

6. Department of Medicine and Therapeutics, Prince of Wales Hospital The Chinese University of Hong Kong Hong Kong China

Abstract

AbstractObjectiveIntracranial arterial calcification (IAC) is a risk factor of ischemic stroke. However, the relationship between IAC patterns and clinical outcome of ischemic stroke remains controversial. We aimed to investigate the correlation between IAC patterns and the effects of reperfusion therapy among acute stroke patients.MethodsConsecutive acute ischemic stroke patients who underwent reperfusion therapy were included. IAC was categorized as intimal or medial. Based on its involvement, IAC was further classified as diffuse or focal. Neurologic dysfunction was assessed by the National Institute of Health stroke scale (NIHSS). Clinical outcome including favorable neurologic outcome (FNO) and early neurologic deterioration (END) were assessed.ResultsOf 130 patients, 117 had IAC. Intimal IAC was identified in 74.6% of patients and medial IAC was present in 64.6% of patients. Diffuse IAC was present in 31.5% of patients. All diffuse IACs were medial pattern. Diffuse IAC was associated with higher baseline NIHSS (p = 0.011) and less FNO (p = 0.047). Compared with patients with focal or single diffuse IAC, patients with multiple diffuse IAC had higher baseline NIHSS (p = 0.002) and less FNO (p = 0.024). Multivariable linear regression (p < 0.001) and logistic regression (p = 0.027) suggested that multiple diffuse IAC was associated with higher baseline NIHSS and less FNO. No significant association was found between END and different IAC patterns.InterpretationMultiple diffuse medial IAC may predict severer neurologic dysfunction and less favorable neurologic outcome after reperfusion therapy in acute stroke patients.

Publisher

Wiley

Subject

Neurology (clinical),General Neuroscience

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