Correlation between collateral circulation and cognitive impairment in patients with acute ischemic stroke / 国际脑血管病杂志

ABSTRACT

Objective To investigate the risk factors for cognitive impairment and their correlation with collateral circulation in patients with acute ischemic stroke.Methods From January 2016 to December 2017,patients with acute ischemic stroke admitted to the Department of Neurology,Jiangmen People's Hospital were enrolled.According to their status of collateral circulation,they were divided into either good collateral circulation group or poor collateral circulation group.According to the Montreal cognitive score,they were divided into cognitive impairment group and non-cognitive impairment group.Multivariate logistic regression analysis identified the independent risk factors for cognitive impairment in patients with acute ischemic stroke.Results A total of 225 patients were enrolled,including 106 females (47.1％) and 119 males (52.9％),aged 47-87 years,average 66.96 ± 9.65 years.The average baseline score of the National Institutes of Health Stroke Scale was 4.5 ± 2.1.Ninety-seven patients (43.1％) had cognitive impairment;79 had obvious stenosis or occlusion at the intracranial and extracranial segments of cerebral arteries;148 (65.8％) had good collateral circulation,and 77 (34.2％) had poor collateral circulation.The proportions of patients with atherosclerotic stroke (P =0.033) and cognitive impairment (P =0.041) in the good collateral circulation group were significantly higher than those in the poor collateral circulation group.There were significant differences in the proportions of patients with large-artery atherosclerotic stroke (P =0.007),anterior circulation stroke (P=0.018),collateral dysfunction (P=0.041),as well as baseline systolic blood pressure (P =0.006),baseline diastolic blood pressure (P =0.013),low-density lipoprotein cholesterol (P=0.021),and homocysteine (P=0.024) between the cognitive impairment group and the non-cognitive impairment group.Multivariate logistic regression analysis showed that baseline systolic blood pressure (odds ratio[OR] 1.007,95％ confidence interval[CI] 1.001-1.012;P =0.036),and large-artery atherosclerotic stroke (OR 2.650,95％ CI 1.490-4.714;P =0.001) were independently positively correlated with cognitive impairment,while the status of collateral circulation was not an independent risk factor for cognitive impairment (P =0.073).Conclusions The status of collateral circulation was associated with cognitive impairment in patients with acute ischemic stroke,but it was not an independent risk factor.