Abstract
ObjectivesTo analyze the effect of metabolic syndrome (MetS) on prognosis of ischemic stroke secondary to intracranial stenosis in Chinese patients.MethodsA prospective cohort of 701 patients with ischemic stroke, caused by intracranial stenosis, were followed at 3-month intervals for 1 year to monitor development of recurrent stroke or death. Imaging was performed using magnetic resonance angiography. MetS was defined using International Diabetes Federation (IDF) criteria.ResultsMetS was identified in 26.0% of the cohort of stroke patients. Patients with MetS were more likely to be female, nonsmokers, and more likely to have a prior history of diabetes mellitus, high blood glucose and a family history of stroke than patients without MetS. During 1-year follow-up, patients with MetS had a non-significantly higher rate of stroke recurrence (7.1%) than patients without MetS (3.9%; P = 0.07). There was no difference in mortality (3.3% versus 3.5%, respectively). Multivariate Cox proportional hazards analysis (adjusting for gender, BMI, smoking, diabetes, and LDL-C) identified an association between that 1-year stroke recurrence and the presence of MetS (hazard ratio 2.30; 95% CI: 1.01–5.22) and large waist circumference (hazard ratio: 2.39; 95% CI: 1.05–5.42). However, multivariable analysis adjusting for the individual components of MetS found no significant associations between MetS and stroke recurrence. There were no associations between these parameters and mortality.ConclusionsChinese patients with symptomatic intracranial atherosclerosis who have MetS, are at higher risk of recurrent stroke than those without MetS. However, MetS was not predictive of stroke recurrence beyond its individual components and one-year mortality.
Highlights
Intracranial artery atherosclerotic stenosis is the principle cause of ischemic stroke in the Chinese population
The presence of symptomatic intracranial stenosis has been shown to account for 33% of cases of acute cerebral infarction and 51% of cases of transient ischemic attack (TIA) [1]
Baseline Characteristics A total of 701 patients with first-ever symptomatic intracranial stenosis were enrolled in the study
Summary
Intracranial artery atherosclerotic stenosis is the principle cause of ischemic stroke in the Chinese population. Annual stroke recurrence rates during the first year after the initial event were reported to be higher among patients with intracranial atherosclerosis (17.1%) than among those vascular lesions (10.9%) [2]. These data are supported by other studies showing high recurrent stroke rates among patients with intracranial arterial stenosis [3,4,5]. Recurrent stroke has been identified as a primary cause of death and disability for stroke survivors [6]. Recognition of patients at high risk of recurrence is, crucial for secondary stroke prevention
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