Correlation between white matter hyperintensities and the outcomes after reperfusion therapy in patients with acute ischemic stroke
10.3760/cma.j.issn.1673-4165.2021.11.003
- VernacularTitle:脑白质高信号与接受再灌注治疗的急性缺血性卒中患者转归的相关性
- Author:
Qijing WANG
1
;
Yixian LIU
;
Jing ZENG
;
Xingchen LIU
;
Feng WANG
;
Yufeng HE
;
Sisi XU
;
Benguo WANG
Author Information
1. 广州中医药大学附属中山中医院2019级硕士研究生，中山 528401
- Keywords:
Stroke;
Brain ischemia;
Thrombolytic therapy;
Endovascular procedures;
Thrombectomy;
White matter;
Treatment outcome;
Cerebral hemorrhage;
Risk factors
- From:
International Journal of Cerebrovascular Diseases
2021;29(11):812-819
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the correlation between white matter hyperintensities (WMHs) and the outcomes after reperfusion therapy in patients with acute ischemic stroke (AIS).Methods:Patients with AIS treated with reperfusion therapy (intravenous thrombolysis, endovascular mechanical thrombectomy or bridging therapy) in the Stroke Center of Zhongshan Hospital of traditional Chinese Medicine from January 2014 to December 2019 were retrospectively enrolled. The clinical baseline data of the patients were collected. The Fazekas scale was used to evaluate the severity of WMHs according to the MRI images. At 90 d after discharge, the modified Rankin Scale was used to evaluate the outcomes. A score of ≤ 2 was defined as good outcome, and a score of >2 was defined as poor outcome. Binary multivariate logistic regression analysis was used to determine the independent risk factors for hemorrhagic transformation (HT), symptomatic intracranial hemorrhage (sICH), and poor outcomes. Results:A total of 676 patients with AIS treated with reperfusion therapy were enrolled. Among them, 506 patients (74.9%) were complicated with WMHs, and 80 (11.8%) had severe WMHs. One hundred and thirty-two patients (19.5%) had HT, 34 (5.0%) had sICH, and 306 (45.3%) had a poor outcome. Multivariate logistic regression analysis showed that severe WMHs was an independent risk factor for the occurrence of HT (odds ratio [ OR] 1.890, 95% confidence interval [ CI] 1.047-3.413; P=0.035) and poor outcomes ( OR 3.366, 95% CI 1.567-7.232; P=0.002) after reperfusion treatment in patients with AIS, but there was no independent correlation with sICH ( OR 8.403, 95% CI 0.891-79.294; P=0.063). Conclusion:Severe WMHs is an independent risk factor for the occurrence of HT and poor outcomes in patients with AIS after reperfusion treatment, but it has no independent correlation with sICH.
