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London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 455 322 Etiology of stroke and risk factors Predictive factors of poor outcome in patients with mild acute ischemic stroke having major artery occlusive disease. T. Kawano1, H. Yamagami2, Y. Kuronuma3, K. Toyoda4, K. Nagatuka5 National cerebral and cardiovascular center, Suita, JAPAN1, National cerebral and cardiovascu-lar center, Suita, JAPAN2, National cerebral and cardiovascular center, Suita, JAPAN3, National ce-rebral and cardiovascular center, Suita, JAPAN4, National cerebral and cardiovascular center, Suita, JAPAN5 Background and Purpose: Major artery occlusive disease is associated with early neurological dete-rioration or recurrence in patients with mild ischemic stroke. We sought to clarify the predictive fac-tors of poor outcome in acute ischemic stroke patients with major cerebral artery disease and with initially mild neurological symptoms. Methods: Between January 2011 and July 2012, 884 patients with acute ischemic stroke were admitted to our stroke center within 7 days after the onset. Among them, patients who met the following criteria were retrospectively investigated: patients with large artery occlusion or stenosis (more than 50%) as a culprit of ischemic lesion, with a premorbid modi-fied Rankin scale (mRS) score ≤1, and with an initial National Institutes of Health Stroke Scale (NI-HSS) score <8. Poor and favorable outcomes were defined as mRS score ≥3 and ≤2 at 90 days after the onset. Results: Ninety six patients (69 male; mean age, 70.7 years old) met the criteria, and 19 patients of them (20%) had a poor outcome. Although initial NIHSS score was similar (median:3 vs. 3), NIHSS score at discharge was higher in patients with poor outcome than in those with favorable outcome (median: 3 vs. 0.5; P<0.001). Incidences of progressing stroke (a NIHSS score worsening of ≥4 points in hospital) and recurrent stroke were higher in poor outcome patients than in favorable outcome (45% vs. 5%, P<0.001 and 32% vs. 14%, P=0.09, respectively). In univariate analysis, age (76.5 vs. 69.3 years old, P < 0.05) , serum BUN(21.1 vs. 16.6 mg/dL, P < 0.05)and BNP levels (238.8 vs. 92.9 pg/mL, P < 0.05), cryptogenic stroke (32% vs. 17%, P < 0.05), and internal carotid artery (ICA) occlusion (15.8% vs. 2.6%, P=0.05) were related to poor outcome. In multivariate anal-ysis, cryptogenic stroke (odds ratio OR, 6.04; 95% confidence interval CI, 1.31-29.7) and ICA occlusion (OR, 9.38; 95%CI, 1.12-105.38)were independently associated with poor outcome. Con-clusions: In mild acute ischemic stroke patients with major cerebral artery occlusive disease, crypto-genic stroke and ICA occlusion can be the predictors of poor outcome at 90 days after the onset.


Karger_ESC London_2013
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