Related risk factors of posterior circulation cerebral infarction and its prognostic factors

Abstract

Objective To probe into the risk factors associated with posterior circulation cerebral infarction, and to evaluate the factors affecting the prognosis of posterior circulation cerebral infarction. Methods One thousand and five hundred thirty-six patients with cerebral infarction, admitted to our hospital from June 2010 to June2012, were chosen in our study; 218 patients were excluded according to the exclusion criteria; 410 patients were eliminated for incomplete information (time of onset, admission systolic blood pressure, diastolic blood pressure, glycated hemoglobin, fasting glucose, 2 h postprandial glucose, previous use of hypoglycemic agents, previous use of insulin, coronary heart disease, atrial fibrillation [AF], smoking, previous infarction or transient ischemic history of seizures, cerebral family history, triglycerides, total cholesterol, high density lipoprotein, low density lipoprotein, apolipoprotein A1, fibrinogen [FIB], and infarct type). The 908 eligible patients were divided into posterior circulation cerebral infarction group (n=431) and anterior circulation cerebral infarction group (n=477) according to their MRI features. Then the 431 patients with posterior circulation cerebral infarction were divided into possible good prognosis group (n=140) and possible poor prognosis group (n=291) according to their Barthel indexes on admission. All data were analyzed with Logistic regression analysis. Results Occurrence of posterior circulation cerebral infarction were mainly related to HbA1c≥8.5% (OR=1.919, P=0.004, 95%CI: 1.230-2.993) and history of using insulin (OR=2.108, P=0. 089, 95%CI: 0.892-4.982). And that of anterior circulation cerebral infarction was mainly related to AF (OR=0.655, P=0.028, 95%CI: 0.449-0.955). The possible prognostic factors of posterior circulation cerebral infarction were HbA1c≥8.5% (OR=2.502, P=0.013, 95%CI: 1.217-5.147), FIB (OR=2.318, P=0.001, 95%CI: 1.381-3.891), time of onset (OR=2.120, P=0.011, 95%CI: 1.191-3.772), and age (OR=1. 022, P=0.015, 95%CI: 1.004-1.039). Conclusion In the prevention of stroke, HbA1c can be one of the clinical biomarkers in judging stroke risk and intervention effect. Key words: Posterior circulation cerebral infarction; Risk factor; Prognosis; Glycosylated hemoglobin