Effect of basilar artery hypoplasia on the outcomes in patients with acute ischemic stroke / 国际脑血管病杂志

ABSTRACT

Objective To investigate the effect of basilar artery hypoplasia (BAH) on the outcomes in patients with acute ischemic stroke.Methods Consecutive patients with acute ischemic stroke admitted to hospital within 7 d after onset were enrolled.The modified Rankin Scale was used to assess the functional outcomes at discharge and 90 d after onset,and 0-2 was defined as a good outcome.BAH was defined as the basilar artery uniform and fine and its diameter ＜2 mm in the level of pons.Demography,vascular risk factors,vascular variation,baseline clinical data,and laboratory examinations were compared between the good outcome group and the poor outcome group.Multivariate logistic regression analysis was used to determine the independent influencing factors of outcomes in patients with acute ischemic stroke.Results A total of 334 patients with acute ischemic stroke were enrolled,including 112 (33.5％) females and 222 (66.5％) males,with an average age of 67.3 ± 12.0 years;28 (8.4％) patients had BAH,260 (77.8％) had good outcomes at discharge,258 (77.2％) had good outcomes at 90 d after onset.The age,baseline National Institutes of Health Stroke Scale (NIHSS) score,fasting blood glucose level,and the proportions of atrial fibrillation,anterior circulation infarction,and non-BAH in the poor outcome group were significantly higher than those in the good outcome group at discharge (all P ＜ 0.05).Multivariable logistic regression analysis showed that the higher baseline NIHSS score (odds ratio [OR] 1.170,95％ confidence interval [CI] 1.088-1.258;P ＜ 0.001) and fasting blood glucose (OR 1.155,95％ CI 1.049-1.272;P =0.004) were the independent risk factors for poor outcome,and BAH (OR 0.190,95 ％ CI 0.039-0.920;P =0.039) was an independent predictor of good outcome at discharge.The age,fasting blood glucose,low-density lipoprotein cholesterol,baseline NIHSS score,and the proportions of smoking,atrial fibrillation,anterior circulation infarction,and non-BAH in the poor outcome group were significantly higher than those in the good outcome group at 90 d after onset (all P ＜0.05).Multivariate logistic regression analysis showed that higher baseline NIHSS score (OR 1.172,95％ CI 1.089-1.262;P ＜0.001) and higher fasting blood glucose (OR 1.156,95％ CI 1.048-1.275;P =0.004) were the independent risk factors for poor outcome,and BAH (OR 0.195,95％ CI 0.040-0.940;P =0.042) was an independent predictor of good outcome at 90 d after the onset.Conclusion BAH is the independent predictor of good outcome in patients with acute ischemic stroke.