ABSTRACT
Objective To investigate the predictive factors of symptomatic intracranial hemorrhage(SICH) and the effect on outcomes after mechanical thrombectomy in patients with acute ischemic strokecaused by anterior circulation tandem occlusion. Methods From January 2014 to September 2018, patients with acute ischemic stroke caused by anterior circulation tandem occlusion and treated by endovascular mechanical thrombectomy from the Departments of Neurology in 5 general hospitals (the First Affiliated Hospital of Henan University of Science and Technology, the Affiliated Hospital of Yangzhou University,General Hospital of Eastern Theatre Command of PLA, Yijishan Hospital of Wannan Medical College,Xinqiao Hospital of Army Medical University of PLA) were enrolled retrospectively. SICH was evaluated according to the criteria of Heidelberg Bleeding Classification. The functional outcome was assessed by the modified Rankin Scale score at 90 d after onset, and 0-2 was defined as good outcome. Multivariate logistic regression analysis was used to determine the effect of SICH on the outcome at 90 d and the independent risk factors for SICH. Results A total of 124 patients with acute ischemic stroke caused by anterior circulation tandem occlusion and treated by endovascular mechanical thrombectomy were enrolled in this study. Among them, 19 (15. 3％) had SICH, 60 (48. 4％) had good outcomes, and 28 (22. 6％) died. The incidence of poor outcomes (94. 7％ vs. 43. 8％; χ2 = 16. 708, P < 0. 001 ) and mortality (57. 9％ vs.16. 2％; P < 0. 001 ) in the SICH group were significantly higher than those in the non-SICH group.Multivariate logistic regression analysis showed that SICH was an independent risk factor for poor outcome(odds ratio [OR] 27. 78, 95％ confidence interval [CI] 2. 60-96. 70; P = 0. 006), while larger infarct core(low ASPECT score) was the only independent predictor of SICH (OR 2. 63, 95％ CI 1. 18-5. 88; P =0. 018). Conclusion In patients with acute ischemic stroke caused by anterior circulation tandem occlusion and treated by endovascular mechanical thrombectomy, SICH is associated with poor outcome and higher mortality at 3 months, and larger preoperative infarction core is an independent predictor of SICH.
ABSTRACT
ObjectiveTo investigate the association of single nucleotide polymorphisms (SNPs)of rs11833579 and rs12425791 on chromosome 12pl3 with cerebral infarction in the Fujian Han population.MethodsA case-control association study containing a total of 216 cases and 279 controls was carried out.The genotypes of two polymorphisms were evaluated by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and direct DNA sequencing followed by association analysis.Results The frequency of G ＞ A genotype of rs12425791 in patients with cerebral infarction was lower than that in the controls (34. 3％ vs 43.4％ , x2 = 4. 298 ,P ＜ 0. 05 ) after stratified by causes of cerebral infarction, there was no significant difference in this genotype between large-artery atherosclerosis and controls.Association analysis was performed by logistic regression model after adjusting by sex, age, hypertension, diabetes mellitus, dyslipidemia, smoking and drinking. Rs12425791 G ＞ A genotype was significantly associated with both cerebral infarction ( OR = 0. 627, 95％ CI 0. 417-0. 941, P = 0. 024 ) and large-artery atherosclerosis ( OR =0. 613, 95％ CI 0. 396-0. 949 ,P =0. 028). G ＞ A genotype might be a potential protective factor in male( OR =0. 597, 95％ CI 0. 364-0. 978, P =0. 041 ). rs11833579 G ＞ A genotype frequency was similar between cases and controls.Conclusion rs12425791 G ＞ A on chromosome 12p13 might be a genetic marker for atherothrombotic brain infarction in Han population of Fujian.