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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Stroke+Cerebrovasc+Dis
2015 ; 24
(5
): 1052-8
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Vertebrobasilar ectasia in patients with lacunar stroke: the secondary prevention
of small subcortical strokes trial
#MMPMID25817614
Nakajima M
; Pearce LA
; Ohara N
; Field TS
; Bazan C
; Anderson DC
; Hart RG
; Benavente OR
J Stroke Cerebrovasc Dis
2015[May]; 24
(5
): 1052-8
PMID25817614
show ga
BACKGROUND: The clinical implications of vertebrobasilar ectasia (VBE) in
patients with cerebral small-artery disease are not well defined. We investigated
whether VBE is associated with recurrent stroke, major hemorrhage, and death in a
large cohort of patients with recent lacunar stroke. METHODS: Maximum diameters
of the vertebral and basilar arteries were measured by magnetic resonance
angiography and computed tomographic angiography in 2621 participants in the
Secondary Prevention of Small Subcortical Strokes trial. VBE was defined a priori
as basilar artery greater than 4.5 mm and/or vertebral artery greater than
4.0 mm. Patient characteristics and risks of stroke recurrence and mortality
during follow-up (median, 3.5 years) were compared between patients with and
without VBE. RESULTS: VBE affecting 1 or more arteries was present in 200 (7.6%)
patients. Patient features independently associated with VBE were increasing age,
male sex, white race ethnicity, hypertension, and higher baseline diastolic blood
pressure. Baseline systolic blood pressure was inversely associated with VBE.
After adjustment for other risk factors, VBE was not predictive of recurrent
stroke (hazard ratio [HR], 1.3; 95% confidence interval [CI], .85-1.9) or major
hemorrhage (HR, 1.5; CI, .94-2.6), but was of death (HR, 1.7; CI, 1.1-2.7).
CONCLUSIONS: In this large well-characterized cohort of patients with recent
lacunar stroke, VBE was predictive of death but not of recurrent stroke or major
hemorrhage. In these exploratory analyses, the frequency of VBE was directly
related to diastolic blood pressure but inversely related to systolic blood
pressure.
|Aged
[MESH]
|Basilar Artery/*pathology
[MESH]
|Clopidogrel
[MESH]
|Dilatation, Pathologic/*etiology
[MESH]
|Double-Blind Method
[MESH]
|Female
[MESH]
|Humans
[MESH]
|Magnetic Resonance Angiography
[MESH]
|Magnetic Resonance Imaging
[MESH]
|Male
[MESH]
|Middle Aged
[MESH]
|Platelet Aggregation Inhibitors/*therapeutic use
[MESH]
|Secondary Prevention
[MESH]
|Statistics, Nonparametric
[MESH]
|Stroke, Lacunar/*complications/*prevention & control
[MESH]
|Ticlopidine/analogs & derivatives/therapeutic use
[MESH]