[Atherosclerosis-related stroke: risk factors, location, outcome]

Area of Science:

• Neurology
• Cardiovascular Medicine
• Epidemiology

Background:

• Stroke remains a leading cause of death and disability worldwide.
• Atherosclerosis is a significant risk factor for ischemic stroke.
• Understanding the specific characteristics and outcomes of different stroke etiologies is crucial for effective management.

Purpose of the Study:

• To compare the clinical characteristics and outcomes of first-ever stroke patients attributed to atherosclerosis with stenosis, atherosclerosis without stenosis, and other etiologies.
• To identify differences in stroke territory and patient outcomes based on the underlying cause.

Main Methods:

• Retrospective analysis of 1114 patients with first stroke due to atherosclerosis and 2159 patients with stroke due to other causes.
• Comparison of demographic and clinical data, including stroke territory (carotid, vertebrobasilar, border-zone).
• Assessment of outcomes, specifically death or major disability.

Main Results:

• Stroke due to atherosclerosis with stenosis occurred more frequently in the carotid territory (66.9%) and border-zone (7.2%) compared to other etiologies.
• Stroke due to atherosclerosis without stenosis showed a higher occurrence in the vertebrobasilar territory (40.1%) than other causes.
• The proportion of patients experiencing death or major disability was substantially higher in the atherosclerosis with stenosis group (18%) versus the atherosclerosis without stenosis group (9.4%).

Conclusions:

• Atherosclerotic stenosis is associated with specific territorial patterns of stroke, particularly in the carotid and border-zone areas.
• Atherosclerosis with stenosis presents a significantly worse prognosis, indicated by a higher rate of death or major disability.
• Distinguishing between atherosclerotic stroke subtypes is essential for risk stratification and treatment strategies.