Document Detail

Non-conventional risk factors were associated with infarct patterns in ischemic stroke.
MedLine Citation:
PMID:  18980799     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Diffusion-weighted imaging (DWI) infarct patterns can play a useful role in the management of ischemic stroke patients, particularly in identifying index stroke mechanisms. Novel vascular risk factors like high sensitivity C-reactive protein (hs-CRP) and the metabolic syndrome have recently been shown to be of prognostic importance following ischemic stroke. We aimed to determine the relationship between these novel factors and infarct patterns noted on DWI. METHODS: A total of 886 patients with acute cerebral infarcts within the MCA territory were prospectively studied. Using the DWI data the patients were divided into four groups: cortical, small (<1cm) superficial, border-zone, and deep infarcts patterns. The independent associations of various infarct DWI patterns vs. hs-CRP and presence of the metabolic syndrome were evaluated after adjusting for the confounders. RESULTS: hs-CRP was highest among patients with cortical infarcts, while the metabolic syndrome was most frequent in patients with border-zone infarcts. Compared to the lowest quartile of hs-CRP level, those in the highest quartile were more likely to have the cortical pattern (OR, 3.55; 95% CI, 1.92-6.56; P<0.001), and less likely to have the deep infarct pattern (OR, 0.49; 95% CI, 0.29-0.81; P=0.006) in logistic regression analyses. There was an independent association between presence of the metabolic syndrome and the border-zone pattern (OR, 1.75; 95% CI, 1.12-2.73; P=0.013). CONCLUSIONS: hs-CRP levels and metabolic derangements are independently associated with infarct pattern in acute ischemic stroke, and may be the potential targets for lessening the clinical impact of certain infarct patterns.
Sa Rah Yoon; Oh Young Bang; Ji Man Hong; Wen Yu Li; Phil Hyu Lee; Bruce Ovbiagele
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-11-05
Journal Detail:
Title:  Clinical neurology and neurosurgery     Volume:  111     ISSN:  1872-6968     ISO Abbreviation:  Clin Neurol Neurosurg     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-01-26     Completed Date:  2009-03-09     Revised Date:  2009-10-14    
Medline Journal Info:
Nlm Unique ID:  7502039     Medline TA:  Clin Neurol Neurosurg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  134-9     Citation Subset:  IM    
Department of Radiology, Kang-Nam Sacred Heart Hospital, Hallym University, Seoul, South Korea.
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MeSH Terms
Brain Infarction / blood,  etiology,  pathology*
Brain Ischemia / complications,  pathology*
C-Reactive Protein / analysis
Cerebral Infarction / blood,  etiology,  pathology
Diffusion Magnetic Resonance Imaging / methods
Image Processing, Computer-Assisted
Metabolic Syndrome X / blood,  complications,  pathology
Middle Aged
Middle Cerebral Artery / metabolism,  pathology
Prospective Studies
Regression Analysis
Risk Factors
Stroke / complications,  pathology*
Reg. No./Substance:
9007-41-4/C-Reactive Protein

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