ORIGINAL RESEARCH article
Front. Neurol.
Sec. Stroke
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1617623
This article is part of the Research TopicQuality of Stroke Care: What Could Be Improved, and How? - Volume IIView all 12 articles
Predictors of Infarction and Outcomes in Capsular Warning Syndrome: A Retrospective Observational Study
Provisionally accepted
Rui-xi Guo1
Tao Wang2*- 1Department of Gynecology, The Affiliated Hospital of Yan'an University, Yan'an, Shaanxi, China, Yan'an, China
- 2Yan'an People's Hospital, Yan’an, Shaanxi, China
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Background: Capsular warning syndrome (CWS), a rare subtype of transient ischemic attack, is associated with a high risk of progression to acute cerebral infarction. However, predictive factors for infarction and determinants of functional outcome remain inadequately defined.In this retrospective study, we analyzed 89 CWS patients admitted between January 2021 and December 2024. Clinical, laboratory, imaging, and treatment data were collected. Patients were stratified into infarcted and non-infarcted groups based on DWI findings. Infarcted patients were followed for 90 days, with outcomes assessed using the modified Rankin Scale (mRS). LASSO regression was used for variable selection, followed by multivariable logistic regression to identify independent predictors of infarction and favorable 90-day outcomes (mRS 0-2).Results: Of 89 patients, 57 (64%) experienced infarctions. Independent predictors included elevated platelet count (OR=1.02, 95% CI: 1.01-1.04, p=0.002), higher NIHSS score (OR=1.96, 95% CI: 1.25-3.55, p=0.011), higher ABCD2 score (OR=1.86, 95% CI: 1.04-3.60, p=0.047), intracranial atherosclerosis (OR=10.5, 95% CI: 1.54-99.0, p=0.024), and male sex (OR=5.57, 95% CI: 1.32-27.9, p=0.024).Among 57 infarcted patients, tirofiban infusion was the only independent predictor of favorable outcome (OR = 0.01, CI: 0.00-0.07, p<0.001).In CWS, infarction risk is independently associated with platelet count, clinical severity, vascular pathology, and sex. Tirofiban may improve short-term outcomes in infarcted patients. Prospective multicenter studies are needed to validate these findings.
Keywords: Capsular warning syndrome, Transient ischemic attack (TIA), LASSO regression, Infarction, Tirofiban
Received: 24 Apr 2025; Accepted: 14 Jul 2025.
Copyright: © 2025 Guo 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) or licensor 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: Tao Wang, Yan'an People's Hospital, Yan’an, Shaanxi, China
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