Brain Frailty and Outcomes of Acute Minor Ischemic Stroke With Large-Vessel Occlusionopen access
- Authors
- Park, Je-Woo; Kim, Joon-Tae; Lee, Ji Sung; Kim, Beom Joon; Yoo, Joonsang; Han, Jung Hoon; Kim, Bum Joon; Kim, Chi Kyung; Kim, Jae Guk; Baik, Sung Hyun; Park, Jong-Moo; Kang, Kyusik; Lee, Soo Joo; Park, Hyungjong; Cha, Jae-Kwan; Park, Tai Hwan; Lee, Kyungbok; Lee, Jun; Hong, Keun-Sik; Lee, Byung-Chul; Kim, Dong-Eog; Choi, Jay Chol; Kwon, Jee-Hyun; Shin, Dong-Ick; Sohn, Sung Il; Lee, Sang-Hwa; Ryu, Wi-Sun; Lee, Juneyoung; Bae, Hee-Joon
- Issue Date
- Mar-2024
- Publisher
- KOREAN NEUROLOGICAL ASSOC
- Keywords
- brain frailty; white-matter hyperintensity; acute ischemic stroke; large-vessel occlusion; acute minor stroke
- Citation
- JOURNAL OF CLINICAL NEUROLOGY, v.20, no.2, pp 175 - 185
- Pages
- 11
- Journal Title
- JOURNAL OF CLINICAL NEUROLOGY
- Volume
- 20
- Number
- 2
- Start Page
- 175
- End Page
- 185
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/26329
- DOI
- 10.3988/jcn.2023.0181
- ISSN
- 1738-6586
2005-5013
- Abstract
- Background and Purpose The influence of imaging features of brain frailty on outcomes were investigated in acute ischemic stroke patients with minor symptoms and large -vessel occlusion (LVO). Methods This was a retrospective analysis of a prospective, multicenter, nationwide registry of consecutive patients with acute (within 24 h) minor (National Institutes of Health Stroke Scale score=0-5) ischemic stroke with anterior circulation LVO (acute minor LVO). Brain frailty was stratified according to the presence of an advanced white -matter hyperintensity (WMH) (Fazekas grade 2 or 3), silent/old brain infarct, or cerebral microbleeds. The primary outcome was a composite of stroke, myocardial infarction, and all -cause mortality within 1 year. Results In total, 1,067 patients (age=67.2 +/- 13.1 years [mean +/- SD], 61.3% males) were analyzed. The proportions of patients according to the numbers of brain frailty burdens were as follows: no burden in 49.2%, one burden in 30.0%, two burdens in 17.3%, and three burdens in 3.5%. In the Cox proportional -hazards analysis, the presence of more brain frailty burdens was associated with a higher risk of 1 -year primary outcomes, but after adjusting for clinically relevant variables there were no significant associations between burdens of brain frailty and 1 -year vascular outcomes. For individual components of brain frailty, an advanced WMH was independently associated with an increased risk of 1 -year primary outcomes (adjusted hazard ratio [aHR]=1.33, 95% confidence interval [CI]=1.03-1.71) and stroke (aHR=1.32, 95% CI=1.00-1.75). Conclusions The baseline imaging markers of brain frailty were common in acute minor ischemic stroke patients with LVO. An advanced WMH was the only frailty marker associated with an increased risk of vascular events. Further research is needed into the association between brain frailty and prognosis in patients with acute minor LVO.
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