Background
Methods
Study population
Study variables
Clinical characteristics
Smoking status
Vascular imaging of ECAS and ICAS
Statistical analysis
Results
Patient characteristics
Variables | Overall (n = 2864) | No ECAS or ICAS (n = 1388) | Only ECAS (n = 141) | Only ICAS (n = 1074) | ECAS + ICAS (n = 261) |
P value |
---|---|---|---|---|---|---|
Age (Mean ± SD) | 61.9 ± 11.2 | 61.2 ± 11.2 | 64.7 ± 10.4 | 62.1 ± 11.5 | 63.6 ± 10.1 | <0.001 |
Gender (male) | 1944(67.8) | 938(67.6) | 110(78.0) | 696(64.8) | 200(76.6) | <0.001 |
Stroke risk factors | ||||||
Diabetes mellitus | 991(34.6) | 414(29.3) | 50(35.5) | 418(38.9) | 109(41.8) | <0.001 |
Hypertension | 2238(78.1) | 1056(76.1) | 105(74.5) | 866(80.6) | 211(80.8) | 0.02 |
Hyperlipidemia | 2173(75.9) | 1042(75.1) | 119(84.4) | 807(75.1) | 205(78.5) | 0.05 |
Family history of stroke | 296(10.3) | 122(8.8) | 16(11.4) | 112(10.4) | 46(17.6) | <0.001 |
History of cerebral ischemia | 2018(70.5) | 930(67.0) | 117(83.0) | 772(71.9) | 199(76.3) | <0.001 |
History of hemorrhagic stroke | 54(1.9) | 29(2.1) | 3(2.1) | 19(1.8) | 3(1.2) | 0.73 |
Coronary heart disease | 228(8.0) | 102(7.4) | 17(12.1) | 88(8.2) | 21(8.1) | 0.30 |
Heavy drinking | 142(5.0) | 66(4.8) | 9(6.4) | 51(4.8) | 16(6.1) | 0.66 |
Smoking status | <0.001 | |||||
Never smoker | 1568(54.8) | 774(55.8) | 53(37.6) | 623 (58.0) | 118 (45.2) | |
Former smoker | 247(8.6) | 118(8.5) | 17(12.1) | 84 (7.8) | 28 (10.7) | |
Current smoker | 1049(36.6) | 496(35.7) | 71(50.4) | 367 (34.2) | 115 (40.1) | |
Comorbidities | ||||||
COPD | 12(0.4) | 8(0.6) | 1(0.7) | 2(0.2) | 1(0.4) | 0.47 |
Hepatic cirrhosis | 7(0.2) | 1(0.1) | 0(0.0) | 5(0.5) | 1(0.4) | 0.22 |
Peptic ulcer or previous GIB | 80(2.8) | 43(3.1) | 6(4.3) | 23(2.1) | 8(3.1) | 0.34 |
Arthritis | 46(1.6) | 16(1.2) | 3(2.1) | 26(2.4) | 1(0.4) | 0.03 |
Dementia | 19(0.7) | 8(0.6) | 1(0.7) | 9(0.8) | 1(0.4) | 0.81 |
Cancer | 48(1.7) | 23(1.7) | 5(3.6) | 17(1.6) | 3(1.2) | 0.32 |
Peripheral angiopathy | 21(0.7) | 9(0.7) | 1(0.7) | 7(0.7) | 4(1.5) | 0.47 |
Index event | 0.01 | |||||
Transient ischemic attack | 208(7.3) | 106(7.6) | 19(13.5) | 62(5.8) | 21(8.1) | |
Acute ischemic stroke | 2656(92.7) | 1282(92.4) | 122(86.5) | 1012(94.2)) | 240(92.0) | |
SBP at admission, mm Hg (median, IQR) | 150(135–167) | 150(136–165) | 150(130–165) | 150(135–170) | 150(135–162) | 0.31 |
DBP at admission, mm Hg (median, IQR) | 88(80–95) | 89(80–96) | 85(80–90) | 87(80–95) | 85(80–95) | 0.23 |
NIHSS at admission (median, IQR) | 4(1–7) | 3(1–5) | 3(1–5) | 4(2–8) | 5(2–10) | <0.001 |
Fasting blood glucose, mmol/L (median, IQR) | 5.4(4.8–6.8) | 5.3(4.7–6.6) | 5.3(4.8–6.2) | 5.7(4.9–7.2) | 5.8(4.8–7.1) | <0.001 |
TG, mmol/L (median, IQR) | 1.5(1.1–2.1) | 1.5(1.1–2.2) | 1.6(1.1–2.1) | 1.5(1.1–2.1) | 1.4(1.1–2.0) | 0.15 |
TC, mmol/L (median, IQR) | 4.66(4.00–5.38) | 4.67(4.06–5.40) | 4.58(3.87–5.33) | 4.68(3.98–5.38) | 4.50(3.95–5.35) | 0.15 |
HDL, mmol/L (median, IQR) | 1.12(0.96–1.32) | 1.15(0.98–1.36) | 1.08(0.95–1.29) | 1.09(0.95–1.29) | 1.08(0.91–1.27) | <0.001 |
LDL, mmol/L (median, IQR) | 2.82(2.27–3.45) | 2.83(2.26–3.43) | 2.74(2.28–3.40) | 2.84(2.28–3.47) | 2.82(2.25–3.49) | 0.91 |
Proportion of ECAS and ICAS
Association between smoking status and ECAS or ICAS
Arterial stenosis | Category | Unadjusted OR |
P value | Adjusted OR1
|
P value | Adjusted OR2
|
P value | Adjusted OR3
|
P value |
---|---|---|---|---|---|---|---|---|---|
ECAS | Previous smoking vs. never | 1.82(1.27–2.61) | 0.001 | 1.57(1.07–2.30) | 0.02 | 1.49(1.01–2.09) | 0.04 | 1.42(0.92–2.18) | 0.11 |
Current smoking vs. never | 1.76(1.41–2.20) | <0.001 | 1.82(1.39–2.38) | <0.001 | 1.74(1.33–2.27) | <0.001 | 1.47(1.09–1.99) | <0.01 | |
Smoking vs. never | 1.77(1.43–2.19) | <0.001 | 1.76(1.36–2.26) | <0.001 | 1.67(1.30–2.16) | <0.001 | 1.46(1.09–1.94) | <0.01 | |
ICAS | Previous smoking vs. never | 0.93(0.71–1.21) | 0.58 | 0.94(0.71–1.25) | 0.66 | 0.91(0.69–1.22) | 0.54 | 1.01(0.71–1.44) | 0.95 |
Current smoking vs. never | 0.95(0.81–1.11) | 0.51 | 1.01(0.84–1.22) | 0.91 | 0.99(0.82–1.20) | 0.93 | 0.92(0.73–1.15) | 0.45 | |
Smoking vs. never | 0.94(0.82–1.10) | 0.45 | 1.00(0.83–1.19) | 0.95 | 0.97(0.82–1.17) | 0.77 | 0.93(0.75–1.16) | 0.53 | |
Intra-ICA | Previous smoking vs. never | 1.61(0.96–2.72) | 0.07 | 1.42(0.98–2.11) | 0.21 | 1.39(0.80–2.42) | 0.25 | 1.26(0.65–2.45) | 0.50 |
Current smoking vs. never | 1.58(1.14–2.18) | 0.005 | 1.44(0.82–2.47) | 0.06 | 1.34(0.91–1.98) | 0.14 | 1.13(0.71–1.79) | 0.61 | |
Smoking vs. never | 1.58(1.16–2.16) | 0.003 | 1.43(0.99–2.07) | 0.05 | 1.35(0.94–1.95) | 0.11 | 1.15(0.74–1.79) | 0.52 | |
MCA | Previous smoking vs. never | 1.01(0.75–1.36) | 0.94 | 1.01(0.74–1.37) | 0.97 | 0.99(0.73–1.36) | 0.97 | 1.05(0.72–1.53) | 0.79 |
Current smoking vs. never | 1.03(0.87–1.23) | 0.70 | 1.02(0.83–1.25) | 0.86 | 1.01(0.82–1.24) | 0.94 | 0.89(0.70–1.14) | 0.36 | |
Smoking vs. never | 1.03(0.88–1.21) | 0.73 | 1.02(0.84–1.23) | 0.87 | 1.01(0.83–1.22) | 0.96 | 0.92(0.73–1.16) | 0.50 | |
ACA | Previous smoking vs. never | 1.01(0.62–1.65) | 0.97 | 1.17(0.69–1.97) | 0.56 | 1.12(0.66–1.89) | 0.69 | 0.93(0.49–1.76) | 0.83 |
Current smoking vs. never | 0.86(0.63–1.16) | 0.31 | 1.09(0.76–1.56) | 0.64 | 1.04(0.73–1.50) | 0.82 | 1.00(0.65–1.54) | 0.99 | |
Smoking vs. never | 0.89(0.67–1.17) | 0.39 | 1.11(0.79–1.55) | 0.56 | 1.06(0.75–1.49) | 0.74 | 0.99(0.66–1.48) | 0.94 | |
PCA | Previous smoking vs. never | 1.16(0.84–1.60) | 0.37 | 1.29(0.92–1.83) | 0.14 | 1.24(0.88–1.76) | 0.22 | 1.40(0.93–2.11) | 0.10 |
Current smoking vs. never | 0.71(0.58–0.88) | 0.001 | 0.91(0.71–1.16) | 0.45 | 0.88(0.68–1.13) | 0.32 | 0.92(0.68–1.23) | 0.57 | |
Smoking vs. never | 0.79(0.65–0.96) | 0.01 | 0.99(0.79–1.25) | 0.94 | 0.96(0.76–1.21) | 0.72 | 1.02(0.77–1.34) | 0.90 | |
BA | Previous smoking vs. never | 0.91(0.53–1.56) | 0.73 | 0.90(0.51–1.60) | 0.73 | 0.83(0.47–1.47) | 0.52 | 0.79(0.40–1.53) | 0.48 |
Current smoking vs. never | 0.71(0.51–1.00) | 0.05 | 0.81(0.55–1.20) | 0.30 | 0.81(0.54–1.20) | 0.28 | 0.88(0.56–1.40) | 0.59 | |
Smoking vs. never | 0.75(0.55–1.02) | 0.07 | 0.83(0.58–1.20) | 0.33 | 0.81(0.56–1.17) | 0.26 | 0.86(0.56–1.32) | 0.48 |