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London, United Kingdom 2013 Cerebrovasc Dis 2013; 35 (suppl 3)1-854 167 Table: Target Adherence to NCEP III Guidelines, According to Individually-Calculated LDL goals.(*Calculated for 370 of total cohort in whom LDL checked) Target LDL Proportion of total cohort, % (N) Number for whom LDL avail-able Within tar-get (%)* p-value NCEP III 2002 0-1 risk factor (RF) <4.14mM 1.1 (7) 5 80.0 2+ RFs,10-year risk <3.36mM 35.4 >20% 0.001 (218) 110 66.4 2+ RFs, 10-year risk >20%, or CHD/risk equivalent <2.59mM 63.5 (391) 255 46.2 16:30-18:00 Oral Session Room 17 Acute stroke: clinical patterns and practice Chairs: J.S. Kim, South Korea and K. Spengos, Greece 1 Acute stroke: clinical patterns and practice 16:30 - 16:40 Predictors of stroke onset time from CT perfusion imaging S. Agarwal1, D. J. Scoffings2, J. Mitchell3, P. J. Barry4, E. W. O’Brien5, P. J. Martin6, J.-C. Bar-on7, E. A. Warburton8 Clinical Neurosciences, University of Cambridge, Cambridge, UNITED KINGDOM1,De-partment of Radiology, Addenbrooke’s Hospital, Cambridge, UNITED KINGDOM2, Stroke Unit, Addenbrooke’s Hospital, Cambridge, UNITED KINGDOM3, Stroke Unit, Addenbrooke’s Hospital, Cambridge, UNITED KINGDOM4, Stroke Unit, Addenbrooke’s Hospital, Cam-bridge, UNITED KINGDOM5, Neurology Unit, Addenbrooke’s Hospital, Cambridge, UNITED KINGDOM6, Clinical Neurosciences, University of Cambridge; INSERM UMR894, Universi-té Paris, Cambridge/Paris, UNITED KINGDOM7, Stroke Unit, Addenbrooke’s Hospital/Clini-cal Neurosciences, University of Cambridge, Cambridge, UNITED KINGDOM8 Background: Strokes of unclear time of onset occur in about 25% of cases. Current treatment guidelines preclude such patients from thrombolytic therapy. Imaging dynamic physiological changes in acute stroke using CT perfusion and vascular imaging, we investigated whether per-fusion and vascular variables relate to time of stroke onset. Methods: We studied a cohort of patients with middle cerebral artery stroke imaged with whole head CT perfusion imaging with concomitant CT angiography within 4.5 hours of observed symptom onset. ASPECTS score was applied to deconvolution derived maps for Cerebral Blood Volume (CBV), Cerebral Blood Flow (CBF) and Mean Transit Time (MTT). Site of vascular occlusion was noted in each case and collateral blood vessels were described using a previously validated semi quantitative score. Mismatch was described as the difference in AS-PECTS score between CBV-CBF and CBV-MTT. Time of stroke onset was divided into epochs of 0-1.5, 1.5-3 and 3-4.5 hours respectively. Results: N=86 patients, with a mean age of 71.7 ± 14.1 years, were imaged at a mean time of 125.0 ± 47.8 minutes from known symptom onset. Using an ordinal regression analysis, CBV/ CBF mismatch (r2=0.074, p=0.02) and CBV/MTT mismatch (r2=0.068, p=0.03) were weak, but significant predictors of time of onset epoch. Mean collateral score did not predict onset time (r2=0.01, p=0.263). Conclusions: CT perfusion markers may be used as a surrogate for stroke onset within the cur-rently licenced thrombolysis window. This has potential applications for guiding therapy and merits further evaluation in relation to clinical outcomes.


Karger_ESC London_2013
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