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Recurrent stroke in...
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Johansson, EliasUmeå universitet,Medicin,Klinisk neurovetenskap
(författare)
Recurrent stroke in symptomatic carotid stenosis awaiting revascularization : A pooled analysis
- Artikel/kapitelEngelska2016
Förlag, utgivningsår, omfång ...
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Wolters Kluwer,2016
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printrdacarrier
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LIBRIS-ID:oai:DiVA.org:umu-117380
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-117380URI
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https://doi.org/10.1212/WNL.0000000000002354DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:132917028URI
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Språk:engelska
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Sammanfattning på:engelska
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Objective: We aimed to quantify the risk and predictors of ipsilateral ischemic stroke in patients with symptomatic carotid stenosis awaiting revascularization (carotid endarterectomy [CEA] or carotid artery stenting) by pooling individual patient data from recent prospective studies with high rates of treatment with modern stroke prevention medications.Methods: Data were included from 2 prospective hospital-based registries (Umea, Barcelona) and one prospective population-based study (Dublin). Patients with symptomatic 50%-99% carotid stenosis eligible for carotid revascularization were included and followed for early recurrent ipsilateral stroke or retinal artery occlusion (RAO).Results: Of 607 patients with symptomatic 50%-99% carotid stenosis, 377 met prespecified inclusion criteria. Ipsilateral recurrent ischemic stroke/RAO risk pre-revascularization was 2.7% (1 day), 5.3% (3 days), 11.5% (14 days), and 18.8% (90 days). On bivariate analysis, presentation with a cerebral vs ocular event was associated with higher recurrent stroke risk (log-rank p = 0.04). On multivariable Cox regression, recurrence was associated with older age (adjusted hazard ratio [HR] per 10-year increase 1.5, p = 0.02) with a strong trend for association with cerebral (stroke/TIA) vs ocular symptoms (adjusted HR 2.7, p = 0.06), but not degree of stenosis, smoking, vascular risk factors, or medications.Conclusions: We found high risk of recurrent ipsilateral ischemic events within the 14-day time period currently recommended for CEA. Randomized trials are needed to determine the benefits and safety of urgent vs subacute carotid revascularization within 14 days after symptom onset.
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Biuppslag (personer, institutioner, konferenser, titlar ...)
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Cuadrado-Godia, Elisa
(författare)
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Hayden, Derek
(författare)
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Bjellerup, JakobUmeå universitet,Medicin
(författare)
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Ois, Angel
(författare)
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Roquer, Jaume
(författare)
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Wester, PerKarolinska Institutet,Umeå universitet,Medicin(Swepub:umu)pewe0002
(författare)
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Kelly, Peter J.
(författare)
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Umeå universitetMedicin
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Neurology: Wolters Kluwer86:6, s. 498-5040028-38781526-632X
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