Features of prediction of fatal and non-fatal cases of ischemic stroke in patients with peripheral atherosclerosis in the long-term period

Abstract

Introduction. According to official statistics, stroke ranks second in the structure of mortality in Russia after coronary heart disease. Mortality and morbidity rates from this pathology among people of working age have recently increased by more than 30%. It should be clarified that the main cause influencing the development of acute cerebrovascular accident is hemodynamically significant atherosclerosis of the carotid vessels. Moreover, the pathological process itself can progress rapidly, or, on the contrary, remain stable for a long time.Aim. To assess the features of the development of fatal and non-fatal cases of ischemic stroke and develop an optimal approach to its assessment in patients with peripheral atherosclerosis in the long-term period.Materials and methods. The study included a group of 519 patients with atherosclerotic lesions of various vascular beds. The average age of the examined patients was 60.0 ± 8.7 years.All persons underwent standard biochemical studies, a set of instrumental studies, in the presence of clinical manifestations that arouse suspicion of atherosclerotic lesions of the vascular pools, coronary angiography, angiography of the renal vessels, brachiocephalic arteries and arteries of the lower extremities were performed. The second stage of the work included a prospective follow-up of patients for three years with an assessment of the endpoints.Results. In the course of the statistical analysis, it was revealed that factors such as a history of amputation of the lower limb (p = 0.048), chronic ischemia of the lower extremities (p = 0.016), atherosclerosis of the abdominal aorta (p = 0.024) influenced the risk of developing non-fatal ischemic stroke in examined patientsConclusions. The complex analysis carried out made it possible to develop an original nomogram for assessing the risk of developing fatal and non-fatal cases of ischemic stroke in the long-term period, which can be used in real clinical practice.