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Tytuł:
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Risk Factors Control and Early Recurrent Cerebral Infarction in Patients with Symptomatic Intracranial Atherosclerotic Disease.
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Autorzy:
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Del Brutto VJ; Department of Neurology, University of Miami Miller School of Medicine, Miami, FL. Electronic address: .
Liebeskind DS; University of California at Los Angeles, Los Angeles, CA. Electronic address: .
Romano JG; Department of Neurology, University of Miami Miller School of Medicine, Miami, FL. Electronic address: .
Campo-Bustillo I; Department of Neurology, University of Miami Miller School of Medicine, Miami, FL. Electronic address: .
Cotsonis G; Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA. Electronic address: .
Nizam A; Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA. Electronic address: .
Prabhakaran S; Department of Neurology, The University of Chicago, Chicago, IL. Electronic address: .
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Corporate Authors:
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MYRIAD investigators
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Źródło:
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Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2021 Sep; Vol. 30 (9), pp. 105914. Date of Electronic Publication: 2021 Jun 30.
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Typ publikacji:
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Journal Article; Multicenter Study; Observational Study
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Język:
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English
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Imprint Name(s):
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Publication: Philadelphia, PA : Saunders
Original Publication: New York, NY : Demos Publications, [1991-
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MeSH Terms:
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Risk Reduction Behavior*
Secondary Prevention*
Antihypertensive Agents/*therapeutic use
Cerebral Infarction/*prevention & control
Hypolipidemic Agents/*therapeutic use
Intracranial Arteriosclerosis/*therapy
Platelet Aggregation Inhibitors/*therapeutic use
Aged ; Blood Pressure/drug effects ; Cerebral Infarction/diagnostic imaging ; Cerebral Infarction/etiology ; Cerebral Infarction/physiopathology ; Exercise ; Female ; Humans ; Intracranial Arteriosclerosis/complications ; Intracranial Arteriosclerosis/diagnostic imaging ; Intracranial Arteriosclerosis/physiopathology ; Male ; Medication Adherence ; Middle Aged ; Prospective Studies ; Recurrence ; Risk Assessment ; Risk Factors ; Sedentary Behavior ; Smoking Cessation ; Time Factors ; Treatment Outcome ; United States
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References:
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Grant Information:
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R01 NS084288 United States NS NINDS NIH HHS; U24 NS107267 United States NS NINDS NIH HHS
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Contributed Indexing:
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Keywords: Intracranial Atherosclerotic Disease; Medication Compliance; Stroke Recurrence; Vascular risk factors
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Substance Nomenclature:
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0 (Antihypertensive Agents)
0 (Hypolipidemic Agents)
0 (Platelet Aggregation Inhibitors)
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Entry Date(s):
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Date Created: 20210703 Date Completed: 20210830 Latest Revision: 20220902
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Update Code:
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20240105
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PubMed Central ID:
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PMC8384672
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DOI:
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10.1016/j.jstrokecerebrovasdis.2021.105914
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PMID:
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34217065
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Background: The risk of early recurrent cerebral infarction (RCI) is high in patients with symptomatic intracranial atherosclerotic disease (IAD). We sought to determine the relationship between risk factor control and early RCI risk among patients with symptomatic IAD.
Methods: We analyzed participants with symptomatic IAD in the multi-center prospective observational MYRIAD study. Risk factor control was assessed at 6-8-week follow-up. Optimal risk factor control was defined by target systolic blood pressure, being non-smoker, target physical activity, and antiplatelet and antilipidemic therapy compliance. Age-adjusted associations were calculated between risk factor control and RCI determined by MRI-evident new infarcts in the territory of the stenotic vessel at 6-8 weeks from the index event.
Results: Among 82 participants with clinical and brain MRI information available 6-8 weeks after the index event (mean age 63.5 ±12.5 years, 62.2% men), RCI occurred in 21 (25.6%) cases. At 6-8-week follow-up, 37.8% had target systolic blood pressure, 92.7% were non-smokers, 51.2% had target physical activity, and 98.8% and 86.6% were compliant with antiplatelet and antilipidemic therapy, respectively. Optimal risk factor control increased from 4.9% at baseline to 19.5% at 6-8-week follow-up (p=0.01). None of the participants with optimal risk factor control at follow-up had RCI (0% vs. 31.8%, p<0.01).
Conclusions: Only one-fifth of MYRIAD participants had optimal risk factor control during early follow-up. Approximately half and two-thirds had physical inactivity and uncontrolled systolic blood pressure, respectively. These risk factors may represent important therapeutic targets to prevent early RCI in patients with symptomatic IAD.
Competing Interests: Declaration of Competing Interest V.J. Del Brutto has salary support from the Florida Regional Coordinating Center for the NINDS Stroke Trials Network; S. Prabhakaran has research salary support for role as PI (MPI) of MYRIAD from NIH/NINDS (1R01NS084288). Receives compensation from AHRQ/NIH grants, Abbvie consulting, and UpToDate royalties; D.S. Liebeskind has research salary support for role as PI (MPI) of MYRIAD from NIH/NINDS (1R01NS084288); I. Campo-Bustillo has salary support from R01 grant NIH/NINDS (1R01NS084288) to the University of Miami for role as MyRIAD Project Manager; G. Cotsonis has research salary support for role as biostatistician of MYRIAD from NIH/NINDS (1R01NS084288); A. Nizam has research salary support for role as biostatistician of MYRIAD from NIH/NINDS (1R01NS084288); J.G. Romano has research salary support for role as PI (MPI) of MYRIAD from NIH/NINDS (1R01NS084288)
(Copyright © 2021 Elsevier Inc. All rights reserved.)
