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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Ischemic stroke subtypes : a population-based study of functional outcome, survival, and recurrence
G W Petty1, R D Brown, J P Whisnant
1Division of Cerebrovascular Diseases, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA. petty.george@mayo.edu
Stroke
|May 8, 2000
Summary
Early ischemic stroke recurrence is highest for atherosclerosis (ATH) and survival is poorest for cardioembolic (CE) stroke. Lacunar (LAC) stroke patients experience better functional outcomes. This population-based study highlights subtype-specific risks.
Area of Science:
- Neurology
- Epidemiology
- Cardiology
Background:
- Limited population-based data exists on functional outcomes, survival rates, and recurrence patterns for different ischemic stroke subtypes.
- Understanding these differences is crucial for effective patient management and prognosis.
Purpose of the Study:
- To investigate and compare functional outcomes, survival rates, and recurrent stroke events across major ischemic stroke subtypes in a population-based cohort.
- To identify predictors of survival and recurrence based on stroke etiology.
Main Methods:
- A cohort of 442 first-time ischemic stroke patients from Rochester, Minnesota (1985-1989) was identified and categorized into four subtypes: atherosclerosis (ATH), cardioembolic (CE), lacunar (LAC), and infarct of uncertain cause (IUC).
- Functional outcome was assessed using the Rankin disability score.
- Kaplan-Meier and Cox regression analyses were employed to estimate survival and recurrence rates and identify independent predictors.
Main Results:
- Significant differences in functional disability were observed across subtypes at baseline, 3 months, and 1 year post-stroke, with LAC associated with milder deficits.
- Thirty-day recurrent stroke rates varied significantly: ATH (18.5%), CE (5.3%), LAC (1.4%), and IUC (3.3%). ATH was an independent predictor of early recurrence.
- Five-year mortality rates were highest for CE (80.4%) and lowest for LAC (35.1%) and ATH (32.2%). Stroke subtype independently predicted long-term survival, with CE having the poorest prognosis.
Conclusions:
- Ischemic stroke due to atherosclerosis (ATH) exhibits higher early recurrence rates than other subtypes, potentially influenced by iatrogenic factors.
- Patients with lacunar (LAC) strokes demonstrate superior post-stroke functional status compared to other subtypes.
- Cardioembolic (CE) stroke is associated with the poorest long-term survival outcomes.
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