Different patterns of multiple acute infarctions and long-term prognosis in minor posterior circulation stroke

Abstract

ObjectivesDifferent classification of multiple acute infarctions (MAIs) existed in minor posterior circulation stroke (PCS). We aimed to explore the association between different patterns of MAIs and long-term prognosis in minor PCS. Materials and methodsWe derived data from Chinese Intracranial Atherosclerosis (CICAS) study. We analyzed the clinical features and outcomes in MAIs among anterior circulation stroke (ACS) and PCS. The patterns of MAIs in PCS were further classified into multiple infarcts, multilevel infarcts, or multiterritorial infarcts. The long-term prognosis included ischemic events recurrence and poor functional outcome (modified Rankin Scale, mRS=2–6) in 1 year. Multivariable Cox and logistic regression were adopted respectively to evaluate the correlation of different patterns of MAIs with recurrence and poor functional outcome. ResultsWe totally enrolled 802 patients with minor stroke in CICAS study, including 484 ACS and 318 PCS. In univariate analysis, MAIs were significantly associated with recurrence in ACS (P<0.01), but were significantly correlated with poor functional outcome in PCS (P=0.044). Among the PCS patients, there were 90 patients with multiple infarcts, 32 patients with multilevel infarcts and 36 patients with multiterritorial infarcts. Multivariable Cox regression showed that multiterritorial infarcts were independently associated with ischemic events recurrence (HR, 3.083; 95 % CI, 1.078–8.813). In multivariable logistic regression, significant correlation with poor functional outcome in 1 year was revealed in multilevel infarcts (OR, 2.788; 95 % CI, 1.144–6.797). ConclusionsDifferent patterns of MAIs provide different predictive performances for PCS prognosis. It is imperative to perform more detailed image interpretation of MAIs in PCS.