Risk factors of intracranial atherosclerosis in patients with ischemic stroke A retrospective case series study of 344 patients / 国际脑血管病杂志

ABSTRACT

Objective To investigate the risk factors for intracranial atherosclerosis in patients with ischemic stroke.Methods The demographic data and vascular risk factors in patients with ischemic stroke who performed digital subtraction angiography were analyzed retrospectively.According to the lesion locations,the patients with moderate to severe intracranial arterial stenosis were divided into intracranial internal carotid artery,middle cerebral artery,intracranial vertebral artery,and basilar artery.The démographic data and vascular risk factors among all groups were compared.Results A total of 344 patients with ischemic stroke were recruited,147 (42.7％ ) of them were moderate to severe intracranial arterial stenosis and 197 (57.3％ ) were mild intracranial arterial stenosis.Univariate analysis showed that the proportion of diabetes (34.0％ vs.20.8％,x2 =7.541,P=0.006) or hyperlipidemia (78.9％ vs.66.0％,x2 =6.900,P=0.009) in the moderate to severe intracranial arterial stenosis groups was significantly higher than that in the mild intracranial arterial stenosis group.The levels of total cholesterol (4.656 ±0.955 mmol/L vs.4.401 ±0.882 mmol/L,t =-2.543,P =0.011),low-density lipoprotein cholesterol (3.015 ± 0.817 mmol/L vs.2.741 ± 0.786 mmol/L,t =-3.113,P =0.002),fasting blood glucose (FBG) (6.184 ± 2.127 mmol/L vs.5.568 ±1.772 mmol/L,t =-2.869,P =0.004),and the National Institutes of Health Stroke Scale score (5.48 ± 4.980 vs.4.33 ± 4.094,t =-2.332,P =0.020) were significantly higher.Multivariable logistic regression analysis showed that diabetes (odds ratio [ OR ] 1.907,95％confidence interval [ CI] 1.164-3.124; P =0.010) and low-density lipoprotein cholesterol (OR 1.500,95％ CI 1.133-1.986; P =0.005) were the independent risk factors for moderate to severe intracranial arterial stenosis.Among the patients with different locations of intracranial arteries,there were significant differences in the distribution of the risk factors,such as male (P =0.017),coronary artery disease (P =0.002),and smoking (P =0.026).Conclusion Diabetes and the increased level of low-density lipoprotein cholesterol were the independent risk factors for moderate to severe stenosis of intracranial arteries.The distribution of risk factors for intracranial atherosderosis had location specificity.