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  • 1
    Online Resource
    Online Resource
    Korean Stroke Society ; 2012
    In:  Korean Journal of Stroke Vol. 14, No. 3 ( 2012), p. 122-
    In: Korean Journal of Stroke, Korean Stroke Society, Vol. 14, No. 3 ( 2012), p. 122-
    Type of Medium: Online Resource
    ISSN: 1229-4101
    Language: English
    Publisher: Korean Stroke Society
    Publication Date: 2012
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  • 2
    In: Atherosclerosis, Elsevier BV, Vol. 224, No. 1 ( 2012-09), p. 113-117
    Type of Medium: Online Resource
    ISSN: 0021-9150
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2012
    detail.hit.zdb_id: 1499887-7
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  • 3
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 42, No. 4 ( 2011-04), p. 930-934
    Abstract: The CHADS 2 score is used for risk stratification of ischemic stroke in patients with nonvalvular atrial fibrillation and high CHADS 2 scores are associated with increased risk of stroke. Most components of the CHADS 2 score are also risk factors for atherosclerosis. Therefore, high CHADS 2 scores can be associated with concomitant cerebral atherosclerosis and subsequently atherothrombotic stroke. The aim of this study was to determine whether there are differences in the presence and burden of concomitant cerebral atherosclerosis according to CHADS 2 scores in patients with stroke with nonvalvular atrial fibrillation. Methods— We included 780 consecutive patients with nonvalvular atrial fibrillation who had undergone angiographic studies at index stroke between August 1994 and March 2010 in the present study. We investigated the relationships between the CHADS 2 score and the presence, severity, and pattern of cerebral atherosclerosis and stroke mechanism. Results— Of the 780 patients, concomitant arterial stenosis (≥50%) was found in 231 patients (29.6%). The number of arteries with atherosclerosis increased as the CHADS 2 score increased ( P 〈 0.001) as did the proportion of combined extracranial and intracranial atherosclerosis ( P 〈 0.001). Multivariate analyses showed that high risk based on the CHADS 2 score was an independent predictor of concomitant cerebral atherosclerosis (OR, 3.121; 95% CI, 1.770 to 5.504) and the presence of proximal stenosis at the symptomatic artery (OR, 3.043; 95% CI, 1.458 to 6.350). Conclusions— The CHADS 2 score can predict the presence of concomitant cerebral artery atherosclerosis. Increased risk of stroke in patients with high CHADS 2 scores may be partly explained by increased frequency and burden of cerebral atherosclerosis.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2011
    detail.hit.zdb_id: 1467823-8
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  • 4
    Online Resource
    Online Resource
    SAGE Publications ; 2015
    In:  International Journal of Stroke Vol. 10, No. 4 ( 2015-06), p. 541-546
    In: International Journal of Stroke, SAGE Publications, Vol. 10, No. 4 ( 2015-06), p. 541-546
    Abstract: Multiple potential causes of stroke may coexist in ischemic stroke patients, which may affect long-term outcome. Aim We investigated whether there are differences in long-term mortality among stroke patients with coexisting potential causes. Methods We evaluated the long-term all-cause mortality and stroke or cardiovascular mortality of ischemic stroke patients with multiple potential stroke mechanisms, large artery atherosclerosis, cardioembolism, small vessel occlusion, and negative evaluation admitted to a single center between January 1996 and December 2008. Mortality data were obtained from a National Death Certificate system. Results Total 3533 patients were included in this study: 286 multiple potential mechanisms (138 large artery atherosclerosis + cardioembolism, 105 small vessel occlusion + large artery atherosclerosis, 43 small vessel occlusion + cardioembolism), 1045 large artery atherosclerosis, 701 cardioembolism, 606 small vessel occlusion, and 895 negative evaluation. During a mean follow-up of 3·9 years, as referenced to small vessel occlusion mortality rate, the adjusted mortality hazard ratio was 4·387 (95% confidence interval 3·157–6·096) for large artery atherosclerosis + cardioembolism group, 3·903 (95% confidence interval 3·032–5·024) for cardioembolism group, and 2·121 (95% confidence interval 1·655–2·717) for large artery atherosclerosis. The risk of long-term ischemic stroke mortality or cardiovascular mortality also showed comparable findings: highest in the large artery atherosclerosis + cardioembolism, followed by cardioembolism, and large artery atherosclerosis groups. However, the outcome of small vessel occlusion + large artery atherosclerosis or small vessel occlusion + cardioembolism group was not significantly different from that of small vessel occlusion. Conclusions Coexisting potential causes of ischemic stroke impact on long-term mortality. Identification of coexisting potential causes may help to predict stroke outcomes and to guide planning secondary prevention strategies.
    Type of Medium: Online Resource
    ISSN: 1747-4930 , 1747-4949
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
    detail.hit.zdb_id: 2211666-7
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  • 5
    In: Thrombosis and Haemostasis, Georg Thieme Verlag KG, Vol. 105, No. 04 ( 2011), p. 712-720
    Abstract: The CHADS2 score predicts the risk of ischaemic stroke in patients with non-valvular atrial fibrillation (NVAF). Most components of the CHADS2 score are also risk factors of atherosclerosis, and clustering of these risk factors is associated with increased risk of cardiovascular disease, including ischaemic heart disease. The aim of this study was to investigate whether the CHADS2 score and CHA2DS2-VASc score are predictive of fatal ischaemic heart disease as well as fatal ischaemic stroke. Among 5,268 stroke patients admitted between August 1994 and December 2008, 770 stroke patients with NVAF were enroled in this study. The relationship between CHADS2 score or CHA2DS2-VASc score and the fatal ischaemic events was examined using a Cox regression model. During the follow-up period of 1156.0 ± 1205.0 days (median 729.5, in-terquartile range 179.0 – 1751.0), 321 patients died (41.7%). The CHADS2 score or CHA2DS2-VASc score was positively correlated with fatal ischaemic heart disease as well as with fatal ischaemic stroke. After adjustment for all potential confounders, the occurrence of fatal ischaemic heart disease was independently associated with CHADS2 score or CHA2DS2-VASc score, and previous history of ischaemic heart disease. The CHADS2 and CHA2DS2-VASc scores provide valuable information for identifying high-risk individuals for fatal ischaemic heart and brain diseases among stroke patients with NVAF.
    Type of Medium: Online Resource
    ISSN: 0340-6245 , 2567-689X
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2011
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  • 6
    In: Atherosclerosis, Elsevier BV, Vol. 219, No. 2 ( 2011-12), p. 887-891
    Type of Medium: Online Resource
    ISSN: 0021-9150
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2011
    detail.hit.zdb_id: 1499887-7
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  • 7
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 33, No. 3 ( 2012), p. 286-294
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Atherosclerosis is a systemic disease. Many ischemic stroke patients may have concomitant coronary artery disease (CAD). Detection and treatment of preclinical CAD in stroke patients may improve long-term outcome and survival because CAD is a major cause of death during follow-up in stroke patients. However, association between coronary and cerebral artery atherosclerosis in stroke patients has not fully been investigated. This study aimed at examining the frequency and high-risk groups of CAD in ischemic stroke patients. 〈 i 〉 Methods: 〈 /i 〉 Consecutive patients who were admitted due to acute ischemic stroke between July 2006 and June 2010 were prospectively enrolled in this study. A total of 1,304 patients who underwent MSCT coronary angiography and cerebral angiography were included in this study. By using 64-multislice computed tomography coronary angiography, we investigated the frequency of CAD and association between coronary and cerebral artery atherosclerosis in terms of location and burden (severity and extent) in stroke patients. We also sought to identify high-risk groups for CAD among stroke patients. 〈 i 〉 Results: 〈 /i 〉 The frequency of significant (≧50%) CAD was 32.3% and the frequency of any degree of CAD was 70.1%. Diabetes mellitus, serum levels of total cholesterol, high-density lipoprotein cholesterol and triglyceride, and significant stenosis of the extracranial carotid, intracranial vertebral and basilar arteries were independently associated with CAD. However, no association was found between CAD and significant stenosis of the anterior, middle and posterior cerebral arteries. The association between CAD and cerebral atherosclerosis was stronger with increased severity and extent of cerebral atherosclerosis. When compared to patients with 〈 2 risk factors and without significant cerebral atherosclerosis, those with multiple (≧2) risk factors and atherosclerosis in both the carotid and the vertebrobasilar arteries had very high risks of CAD [odds ratio (OR) 8.36; 95% confidence interval (CI) 4.15–16.87]. The risk was also high in patients with multiple risk factors and atherosclerosis in either the carotid or the vertebrobasilar artery (OR 4.13; 95% CI 2.62–6.51), and in those with 〈 2 risk factors but atherosclerosis in both the carotid and the vertebrobasilar arteries (OR 3.40; 95% CI 1.22–9.47). 〈 i 〉 Conclusions: 〈 /i 〉 A substantial portion of stroke patients had preclinical CAD, and there was a clear relationship between coronary and cerebral artery atherosclerosis in terms of location and burden. The risk of CAD was particularly high in stroke patients with multiple risk factors and atherosclerosis of the carotid and/or vertebrobasilar arteries.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2012
    detail.hit.zdb_id: 1482069-9
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