| Differences in long-term survival in two lacunar stroke types: a 15-year follow-up study in 782 cerebral infarct patients. | |
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MedLine Citation:
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PMID: 18033955 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Mortality studies in lacunar (LAC) stroke are scarce and often characterized by short follow-up time, small patient groups and absence of a nonlacunar stroke group for comparison. Besides, there are no separate long-term prognostic data on LAC stroke subtypes. We performed a long-term mortality study in LAC stroke, subtyping two distinct phenotypes and including nonlacunar ischemic stroke for comparison. METHODS: We performed cross-sectional follow-up, determining survival status, after a median of 15.0 years, in 333 first-ever atherothrombotic (AT), 184 cardioembolic (CE) and 265 LAC strokes, distinguishing LAC stroke with (type 2) or without (type 1) asymptomatic LAC lesions on CT. RESULTS: End of follow-up mortality (in 30-day survivors) in LAC stroke (76.2%) was significantly lower than in CE (87.1%; OR 0.48, 95% CI 0.27-0.84), but not AT strokes (79.0%; OR 0.85, 95% CI 0.57-1.26), and was significantly lower in LAC type 1 than type 2 strokes (70.9 vs. 87.5%; OR 0.35, 95% CI 0.17-0.73). Kaplan-Meier analysis showed most favorable survival in LAC type 1 stroke. In the Cox regression analyses, LAC type 1 stroke appeared as an independent predictor of better survival versus LAC type 2, versus AT and versus CE strokes. CONCLUSIONS: LAC stroke in general cannot be considered a 'benign' stroke type: only long-term survival in patients without concomitant asymptomatic LAC lesions is better than in large-vessel stroke. This difference in long-term survival between the two LAC stroke subtypes should be taken into account in prognostic counselling of individual LAC stroke patients. |
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Authors:
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Julie Staals; Lisette van Raak; Anne Hilton; Jan Lodder |
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Publication Detail:
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Type: Journal Article Date: 2007-11-22 |
Journal Detail:
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Title: Cerebrovascular diseases (Basel, Switzerland) Volume: 25 ISSN: 1421-9786 ISO Abbreviation: Cerebrovasc. Dis. Publication Date: 2008 |
Date Detail:
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Created Date: 2008-02-20 Completed Date: 2008-04-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9100851 Medline TA: Cerebrovasc Dis Country: Switzerland |
Other Details:
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Languages: eng Pagination: 26-31 Citation Subset: IM |
Copyright Information:
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(c) 2007 S. Karger AG, Basel. |
Affiliation:
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Department of Neurology, University Hospital Maastricht, Maastricht, The Netherlands. j.staals@neurologie.azm.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Brain Infarction / diagnosis, etiology, mortality* Case-Control Studies Cross-Sectional Studies Female Follow-Up Studies Humans Leukoaraiosis / complications Male Survival Analysis Survival Rate Tomography, X-Ray Computed |
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