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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Neurol. | doi: 10.3389/fneur.2019.01213

Risk Profile of Ischemic Stroke Caused by Small-Artery Occlusion Versus Deep Intracerebral Hemorrhage

 Zimo Chen1,  Jinglin Mo1, Jie Xu1, Haiqiang Qin1,  Huaguang Zheng1,  Yuesong Pan1, Xia Meng1, Jing Jing1, Xianglong Xiang1 and  Yongjun Wang1*
  • 1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China

Background: Small-artery occlusion (SAO) subtype accounts for a quarter of the cases of ischemic stroke and is mainly caused by pathological changes in cerebral small vessels which also involve in deep intracerebral hemorrhage (dICH). However, the factors that drive some cases to SAO and others to dICH remained incompletely defined.
Material and Methods: This prospective cohort study from the China National Stroke Registry included consecutive patients with ischemic stroke or intracerebral hemorrhage between August 2007 and September 2008. We compared the risk profile between the two subgroups using multivariate logistic regression.
Results: A total of 1135 patients with SAO stroke and 1125 dICH patients were included for analyses. Generally, patients with SAO stroke were more likely to be male (odds ratio [OR] 0.74, confidence interval [CI] 0.58-0.94) and have diabetes (0.30, 0.22-0.40), higher atherogenic lipid profiles, higher body mass index (BMI) (0.96, 0.94-0.99), higher WHtR (waist-height ratio) (0.12, 0.03-0.48), higher platelet (PLT) count (0.84, 0.77-0.91), and higher proportion of abnormal estimated glomerular filtration rate (eGFR﹤90, ml/min/1.73m2) (0.77, 0.62-0.95). Conversely, patients with dICH were more likely to have higher blood pressure parameters, inflammation levels (white blood cell count [WBC count]: 1.61, 1.48-1.76; high sensitivity C-reactive protein [hs-CRP]: 2.07, 1.36-3.16) and high-density lipoprotein-c (HDL-c) (1.57, 1.25-1.98).
Conclusions: The risk profile between SAO stroke and dICH were different. Furthermore, despite of traditional indexes, WHtR, PLT count, inflammation levels, lipid profile and eGFR also play important roles in driving arteriolosclerosis into opposite ends.

Keywords: cerebrovascular disease, Lacunar stroke, intracerebral hemorrhage, risk factor, 2

Received: 18 Aug 2019; Accepted: 30 Oct 2019.

Copyright: © 2019 Chen, Mo, Xu, Qin, Zheng, Pan, Meng, Jing, Xiang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Yongjun Wang, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China, yongjunwang@ncrcnd.org.cn