Baseline characteristics and outcome of stroke patients after endovascular therapy according to previous symptomatic vascular disease and sex.

Peycheva, Marieta; Padlina, Giovanna; Genceviciute, Kotryna; Krasteva, Marina P.; Boronylo, Anna; Goeldlin, Martina B.; Müller, Madlaine; Wenz, Elena S.; Müller, Mandy D.; Hammer, Helly; Bücke, Philipp; Bigi, Sandra; Goeggel Simonetti, Barbara; Hoffmann, Angelika; Umarova, Roza M.; Pilgram-Pastor, Sara; Gralla, Jan; Mordasini, Pasquale; Antonenko, Kateryna and Heldner, Mirjam R. (2024). Baseline characteristics and outcome of stroke patients after endovascular therapy according to previous symptomatic vascular disease and sex. Frontiers in neurology, 15, p. 1293905. Frontiers Media S.A. 10.3389/fneur.2024.1293905

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Aim: The aim of this study was to investigate baseline characteristics and outcome of patients after endovascular therapy (EVT) for acute large vessel occlusion (LVO) in relation to their history of symptomatic vascular disease and sex.

Methods: Consecutive EVT-eligible patients with LVO in the anterior circulation admitted to our stroke center between 04/2015 and 04/2020 were included in this observational cohort study. All patients were treated according to a standardized acute ischaemic stroke (AIS) protocol. Baseline characteristics and successful reperfusion, recurrent/progressive in-hospital ischaemic stroke, symptomatic in-hospital intracranial hemorrhage, death at discharge and at 3 months, and functional outcome at 3 months were analyzed according to previous symptomatic vascular disease and sex.

Results: 995 patients with LVO in the anterior circulation (49.4% women, median age 76 years, median admission NIHSS score 14) were included. Patients with multiple vs. no previous vascular events showed higher mortality at discharge (20% vs. 9.3%, age/sex - adjustedOR = 1.43, p = 0.030) and less independency at 3 months (28.8% vs. 48.8%, age/sex - adjustedOR = 0.72, p = 0.020). All patients and men alone with one or multiple vs. patients and men with no previous vascular events showed more recurrent/progressive in-hospital ischaemic strokes (19.9% vs. 6.4% in all patients, age/sex - adjustedOR = 1.76, p = 0.028) (16.7% vs. 5.8% in men, age-adjustedOR = 2.20, p = 0.035). Men vs. women showed more in-hospital symptomatic intracranial hemorrhage among patients with one or multiple vs. no previous vascular events (23.7% vs. 6.6% in men and 15.4% vs. 5.5% in women, OR = 2.32, p = 0.035/age - adjustedOR = 2.36, p = 0.035).

Conclusions: Previous vascular events increased the risk of in-hospital complications and poorer outcome in the analyzed patients with EVT-eligible LVO-AIS. Our findings may support risk assessment in these stroke patients and could contribute to the design of future studies.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Padlina, Giovanna, Göldlin, Martina Béatrice, Müller, Madlaine, Wenz, Elena Sophie, Müller, Mandy, Hammer, Helly Noemi, Bücke, Philipp Jonas, Bigi, Sandra, Goeggel Simonetti, Barbara, Hoffmann, Angelika, Umarova, Roza, Pilgram-Pastor, Sara Magdalena, Gralla, Jan, Mordasini, Pasquale Ranato, Antonenko, Kateryna, Heldner, Mirjam Rachel

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1664-2295

Publisher:

Frontiers Media S.A.

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

29 Apr 2024 14:32

Last Modified:

06 Jun 2024 13:50

Publisher DOI:

10.3389/fneur.2024.1293905

PubMed ID:

38694775

BORIS DOI:

10.48350/196359

URI:

https://boris.unibe.ch/id/eprint/196359

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