Correlation between ipsilateral posterior cerebral artery laterality and outcome in patients with acute ischemic stroke in the middle cerebral artery territory / 国际脑血管病杂志

ABSTRACT

Objective To investigate the correlation between ipsilateral posterior cerebral artery laterality (PCAL) and the outcomes in patients with ischemic stroke in the middle cerebral artery (MCA) territory. Methods From June 2015 to December 2016, patients with acute ischemic stroke in the MCA territory admitted to the Second People's Hospital of Hefei were enrolled. Magnetic resonance angiography (MRA) was used to assess PCAL. The outcome was evaluated by the modified Rankin scale at 3 months after onset. 0-2 was defined as good outcome and > 2 was defined as poor outcome. Multivariate logistic regression analysis was used to determine the independent influencing factors of clinical outcome. Results A total of 111 patients with ischemic stroke in MCA territory were enrolled, including 47 (42. 3％) PCAL and 30 (27. 0％) poor outcomes. The baseline NIHSS score in the PCAL group was significantly lower than that in the non-PCAL group (5. 13 ± 3. 29 years vs. 7. 03 ± 5. 676 years, t = 2. 058; P = 0. 042). There were significantly differences in the proportion of diabetes mellitus (29. 6％ vs. 10. 0％; χ2 = 4. 583, P = 0. 032), PCAL (51. 9％ vs. 16. 7％;χ2 = 11. 101, P = 0. 001) and smoking (25. 9％ vs. 13. 3％; χ2 = 4. 943, P = 0. 026), as well as age (63. 9 ± 11. 8 years vs. 71. 0 ± 6. 7 years; t = 2. 688, P = 0. 007), baseline diastolic blood pressure (89 ± 13 mmHg vs. 82 ± 10 mmHg; t = -2. 249, P = 0. 025; 1 mmHg = 0. 133 kPa) and baseline NIHSS score (5. 02 ± 3. 67 vs. 9. 47 ± 6. 20; t = 3. 883, P < 0. 001) between the good outcome group and the poor outcome group. Multivariate logistic regression analysis showed that PCAL was associated independently with good outcome (odds ratio [OR] 0. 272, 95％ confidence interval [CI] 0. 083-0. 888; P = 0. 031), while advanced age (OR 1. 088, 95％ CI 1. 022-1. 157; P = 0. 008) and high baseline NIHSS score (OR 1. 224, 95％ CI 1. 077-1. 391; P = 0. 002) were associated independently with poor outcome. Conclusion PCAL is associated independently with good outcome in patients with ischemic stroke in MCA territory.