Document Detail


Outcome in patients with symptomatic occlusion of the internal carotid artery or intracranial arterial lesions: a meta-analysis of the role of baseline characteristics and type of antithrombotic treatment.
MedLine Citation:
PMID:  11641588     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We performed a systematic review of the literature to assess the impact of potential risk factors of recurrent stroke other than a compromised cerebral blood flow in patients with carotid occlusion or intracranial arterial lesions. In addition, we investigated the effect of treatment with aspirin or oral anticoagulation on recurrent stroke rate and assessed whether the incidence of recurrent stroke has decreased over the years. METHODS: We searched Medline (1966 and onwards) and reference lists of identified articles for papers reporting on the recurrent stroke risk in patients with carotid occlusion or intracranial arterial lesions. Two authors independently extracted information from all papers. The influence of study characteristics on the risk of the endpoints 'recurrent stroke', 'ipsilateral stroke' and 'vascular death' was determined by Poisson regression analysis. Rate ratios were calculated per 10 percentage points increase of a characteristic. RESULTS AND CONCLUSIONS: Patients with intracranial carotid stenosis or occlusion had a higher rate of recurrent stroke (rate ratio 1.09; 95% CI 1.05-1.14) than patients with extracranial carotid occlusion or middle cerebral artery stenosis or occlusion. In patients with bilateral carotid occlusion the rate was lower (rate ratio 0.82; 95% CI 0.68-0.98). No other vascular risk factors than hypertension (rate ratio 1.23; 95% CI 1.07-1.41) could be shown to increase the rate of recurrent stroke. Oral anticoagulation but not aspirin had a protective effect on the incidence of recurrent stroke (rate ratio 0.86; 95% CI 0.79-0.93). The reported rates of recurrent stroke in patients with symptomatic occlusion of the internal carotid artery or intracranial arterial lesions have not decreased over the years.
Authors:
C J Klijn; L J Kappelle; A Algra; J van Gijn
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  12     ISSN:  1015-9770     ISO Abbreviation:  Cerebrovasc. Dis.     Publication Date:  2001  
Date Detail:
Created Date:  2001-10-19     Completed Date:  2002-01-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  228-34     Citation Subset:  IM    
Copyright Information:
Copyright 2001 S. Karger AG, Basel
Affiliation:
University Department of Neurology, University Medical Centre Utrecht and the Rudolf Magnus Institute for Neurosciences, Utrecht, The Netherlands. c.j.m.klijn@neuro.azu.nl
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Aged
Anticoagulants / therapeutic use
Arterial Occlusive Diseases / drug therapy*,  epidemiology,  mortality,  prevention & control
Aspirin / therapeutic use
Carotid Artery, Internal*
Female
Fibrinolytic Agents / therapeutic use*
Humans
Incidence
Male
Middle Aged
Netherlands
Recurrence / prevention & control
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Fibrinolytic Agents; 50-78-2/Aspirin

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