Background
Methods
Study population
Admission CT
Leptomeningeal collateral flow assessment
Data collection
Statistical analysis
Results
Baseline characteristics of the patients
All (n = 120) | Pre-stroke warfarin users | P value | ||
---|---|---|---|---|
Yes (n = 29) | No (n = 91) | |||
Demographics, n (%) | ||||
Age > 60 years | 89 (74.2) | 12 (41.4) | 77 (84.6) | < 0.001 |
Male | 37 (30.8) | 8 (27.6) | 29 (31.9) | 0.664 |
Onset to door time < 6 h | 80 (66.7) | 17 (58.6) | 63 (69.2) | 0.291 |
Risk factors, n (%) | ||||
Hypertension | 60 (50.0) | 10 (34.5) | 50 (54.9) | 0.055 |
Diabetes | 16 (13.3) | 3 (10.3) | 13 (14.3) | 0.759 |
Atrial fibrillation | 112 (93.3) | 22 (75.9) | 90 (98.9) | < 0.001 |
Coronary heart disease | 17 (14.2) | 3 (10.3) | 14 (15.4) | 0.76 |
Previous stroke | 16 (13.3) | 2 (6.9) | 14 (15.4) | 0.352 |
Admission examinations, mean ± SD | ||||
INR | 1.15 ± 0.54 | 1.53 ± 1.00 | 1.02 ± 0.09 | < 0.001 |
Systolic blood pressure | 136.88 ± 20.08 | 133.86 ± 23.74 | 137.84 ± 18.81 | 0.356 |
Diastolic blood pressure | 81.31 ± 15.03 | 82.93 ± 13.70 | 80.79 ± 15.47 | 0.507 |
Serum glucose | 7.85 ± 2.40 | 7.45 ± 2.71 | 7.97 ± 2.29 | 0.311 |
Triglyceride | 1.53 ± 1.60 | 1.90 ± 2.65 | 1.40 ± 1.08 | 0.72 |
Cholesterol | 3.97 ± 0.99 | 3.91 ± 1.29 | 3.98 ± 0.88 | 0.325 |
HDL-C | 1.38 ± 0.56 | 1.36 ± 0.79 | 1.39 ± 0.47 | 0.26 |
LDL-C | 2.25 ± 0.72 | 2.16 ± 0.65 | 2.29 ± 0.74 | 0.402 |
Clinical factors, n (%) | ||||
Thrombus location on CTA | 0.078 | |||
ICA + M1 | 28 (23.3) | 6 (20.7) | 22 (24.2) | |
M1 | 54 (45.0) | 9 (31.0) | 45 (49.5) | |
M2 | 38 (31.7) | 14 (48.3) | 24 (26.3) | |
NIHSS scores | 13 (7–18) | 12 (8–16) | 13 (7–18) | |
Thrombolysis | 22 (18.3) | 4 (13.8) | 18 (19.8) | 0.468 |
Intracranial hemorrhage | 27 (22.5) | 5 (17.2) | 22 (24.2) | 0.436 |
Pre-stroke medications, n (%) | ||||
Antihypertensive drugs | 49 (40.8) | 10 (34.5) | 39 (42.9) | 0.424 |
Antidiabetics | 14 (11.7) | 3 (10.3) | 11 (12.1) | 0.549 |
Antiplatelet drugs | 21 (17.5) | 2 (6.90) | 19 (20.9) | 0.084 |
Statins | 21 (17.5) | 7 (24.1) | 14 (15.4) | 0.28 |
Assessment of clinical factors associated with collateral status
Poor (n = 43) | Moderate (n = 52) | Good (n = 25) | P value | Univariate logistic analysis | ||
---|---|---|---|---|---|---|
Poor vs. not poor rLMC | Good vs. not good rLMC | |||||
Age > 60 years | 30 (69.8) | 40 (76.9) | 15 (60.0) | 0.269 | 0.85 (0.36–1.97) | 0.54 (0.21–1.38) |
Hypertension history | 24 (55.8) | 25 (48.1) | 11 (44.0) | 0.601 | 1.36 (0.61–3.07) | 0.85 (0.33–2.21) |
Diabetes | 6 (13.9) | 8 (15.4) | 2 (8.0) | 0.664 | 0.89 (0.28–2.80) | 0.48 (0.09–2.44) |
Atrial fibrillation | 42 (97.7) | 48 (92.3) | 22 (88.0) | 0.282 | 3.50 (0.38–32.55) | 0.61 (0.13–2.97) |
Coronary heart disease | 9 (20.9) | 8 (15.4) | 0 (0.0) | 0.023 | 1.46 (0.51–4.17) | – |
Previous stroke | 5 (11.6) | 10 (19.2) | 1 (4.00) | 0.168 | 0.55 (0.17–1.76) | 0.18 (0.02–1.45) |
Systolic blood pressure | 34.98 ± 19.98 | 137.77 ± 21.91 | 38.28 ± 16.43 | 0.74 | 0.99 (0.95–1.02) | 1.02 (0.97–1.07) |
Diastolic blood pressure | 82.67 ± 16.53 | 80.54 ± 14.04 | 80.56 ± 14.78 | 0.761 | 1.00 (0.96–1.05) | 0.93 (0.87–0.99) |
Serum glucose | 8.33 ± 2.63 | 7.44 ± 2.17 | 7.84 ± 2.41 | 0.252 | 1.12 (0.98–1.40) | 1.09 (0.88–1.34) |
Triglyceride | 1.51 ± 1.40 | 1.48 ± 1.99 | 1.63 ± 0.95 | 0.106 | 1.01 (0.69–1.47) | 1.06 (0.79–1.39) |
Cholesterol | 3.92 ± 0.84 | 3.79 ± 1.09 | 4.43 ± 0.86 | 0.173 | 1.18 (0.75–1.85) | 1.83 (1.16–3.40) |
HDL-C | 1.36 ± 0.44 | 1.38 ± 0.64 | 1.44 ± 0.57 | 0.864 | 0.91 (0.43–1.94) | 1.17 (0.52–2.63) |
LDL-C | 2.35 ± 0.74 | 2.04 ± 0.68 | 2.54 ± 0.67 | 0.008 | 1.33 (0.79–2.24) | 1.99 (1.07–3.72) |
Antihypertensive drugs | 17 (39.5) | 22 (42.3) | 10 (40.0) | 0.959 | 0.89 (0.39–2.03) | 0.91 (0.34–2.40) |
Antidiabetics | 6 (13.9) | 7 (13.5) | 1 (4.00) | 0.44 | 1.04 (0.32–3.37) | 0.27 (0.03–2.31) |
Antiplatelet drugs | 5 (11.6) | 11 (21.2) | 5 (20.0) | 0.449 | 0.49 (0.16–1.54) | 0.93 (0.29–3.05) |
Statins | 3 (6.9) | 13 (25.0) | 5 (20.0) | 0.068 | 0.33 (0.06–0.85) | 1.23 (0.40–3.77) |
Warfarin | 5 (11.6) | 15 (28.9) | 9 (36.0) | 0.045 | 0.21 (0.10–0.83) | 2.11 (0.81–5.48) |
Poor rLMC vs. Not poor rLMC | Good rLMC vs. Not good rLMC | |||
---|---|---|---|---|
OR (95% CI) | P value | OR (95% CI) | P value | |
Unadjusted | 0.21 (0.10–0.83) | 0.021 | 2.11 (0.81–5.84) | 0.125 |
Model 1 | 0.18 (0.05–0.61) | 0.006 | 1.92 (0.66–5.62) | 0.234 |
Model 2 | 0.17 (0.05–0.65) | 0.009 | 2.12 (0.61–7.39) | 0.239 |
Model 3 | 0.06 (0.01–0.37) | 0.002 | 6.03 (0.94–38.71) | 0.058 |
Model 4 | 0.07 (0.01–0.44) | 0.005 | 4.80 (0.68–33.79) | 0.115 |
Association of Prior Warfarin use with stroke severity, Thrombus location, and clinical outcomes
Univariate analysis | Multivariate analysis | |||
---|---|---|---|---|
OR (95% CI) | P value | OR (95% CI) | P value | |
NIHSS scores | ||||
> 14 vs. 0–14 | 0.74 (0.31–1.76) | 0.487 | – | – |
> 5 vs. 0–5 | 1.18 (0.39–3.53) | 0.762 | – | – |
Thrombus location | ||||
ICA + M1 vs. M1/M2 | 0.82 (0.29–2.27) | 0.699 | – | – |
ICA + M1/M1 vs. M2 | 0.38 (0.16–0.91) | 0.03 | 0.37 (0.13–1.03) | 0.056* |
Follow-up mRS scores | ||||
0–3 vs. 4–6 | 1.43 (0.59–3.41) | 0.425 | – | – |
0–2 vs. 3–6 | 1.49 (0.65–3.46) | 0.348 | – | – |