Factors Associated With Impaired Kidney Function and Its Impact on Long-Term Outcome in Young Ischemic Stroke

Introduction Systemic contraceptives increase the risk of ischemic stroke but little is known about the characteristics, mechanisms and long-term outcome post stroke of patients on hormonal contraception. We sought to To assess characteristics and outcome of acute ischemic stroke (AIS) in young women using systemic hormonal contraceptives (SHC) and compare them to strokes in non-contraceptive users. Patients and methods Using the Acute STroke Registry and Analysis of Lausanne (ASTRAL), we analyzed demographics, risk factors, clinical, radiological and treatment data of consecutive female patients of <50 years between 2003 to 2015. We compared groups with and without SHC in a logistic regression analysis. Results Of the 179 female patients of <50 years during the observation period, 57 (39.6%) used SHC, 71.9% of whom, a combined oral contraceptive pill. On logistic regression contraceptive users were significantly younger but had comparable stroke severity. They had less migraine with aura and tobacco use, and more hyperlipidaemia. Also, contraceptive users had significantly less intra and extracranial stenosis and occlusion on arterial imaging, but more focal hypoperfusion on CT-perfusion. Undetermined mechanism of stroke was more frequent with SHC users, whereas rare mechanisms were more frequent in non-users. The contraceptive user group had a more favourable adjusted 12-month outcome with significantly fewer ischemic recurrences after stopping systemic contraception in all. Conclusion Contraceptive users with ischemic strokes are younger and have lesser tobacco use and migraine with aura and more hyperlipidemia. Their stroke mechanism is more often undetermined using a standardised work-up, and their adjusted long-term outcome is more favourable with less stroke recurrence.

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Biomarkers Predictive of Long-Term Outcome After Ischemic Stroke: A Meta-Analysis

World Neurosurgery ◽

10.1016/j.wneu.2021.10.157 ◽

2021 ◽

Author(s):

Sauson Soldozy ◽

Kaan Yağmurlu ◽

Pedro Norat ◽

Mazin Elsarrag ◽

John Costello ◽

...

Keyword(s):

Ischemic Stroke ◽

Meta Analysis ◽

Term Outcome ◽

Long Term Outcome

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Eight year, long term outcome after PTCA: Factors associated with adverse events. The NHLBI PTCA registry

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(96)82362-x ◽

1996 ◽

Vol 27 (2) ◽

pp. 361 ◽

Cited By ~ 3

Author(s):

David R. Holmes ◽

Katherine Detre ◽

Wan Lin Weh ◽

Spencer King ◽

Sheryl Kelsey

Keyword(s):

Adverse Events ◽

Term Outcome ◽

Long Term Outcome ◽

Factors Associated

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Differential impact of white matter hyperintensity on the long-term outcome in ischemic stroke patients with large artery atherosclerosis according to age group

Journal of the Neurological Sciences ◽

10.1016/j.jns.2017.08.3335 ◽

2017 ◽

Vol 381 ◽

pp. 396-397

Author(s):

M. Baik ◽

H.C. Kim ◽

Y.D. Kim ◽

J.H. Heo ◽

H.S. Nam

Keyword(s):

Ischemic Stroke ◽

White Matter ◽

White Matter Hyperintensity ◽

Large Artery ◽

Age Group ◽

Stroke Patients ◽

Differential Impact ◽

Term Outcome ◽

Long Term Outcome

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Abstract TP448: High Residual Platelet Reactivity (hrpr) for Adenosine Diphosphate (adp) Stimuli is a Determinant Factor for Long-term Outcomes in Acute Ischemic Stroke With Anti-platelet Agents

Stroke ◽

10.1161/str.47.suppl_1.tp448 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Jae-Kwan Cha ◽

Eun-Kyu Kim

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Primary Endpoint ◽

Platelet Reactivity ◽

Large Artery ◽

Vascular Events ◽

Term Outcome ◽

Long Term Outcome ◽

Platelet Aggregometry

Background and Purpose: High residual platelet activation (HRPA) after ADP stimuli has associated with recurrent vascular events in acute atherothrombosis with the use of antiplatelet agents (APAs). However, there has been little evidence supporting this association in acute ischemic stroke (AIS). In this study, we evaluated the influences of HRPR after ADP stimuli on the 1-year incidence of recurrent cardiovascular events and mortality in AIS with APAs. Methods: We conducted an observational, referral center cohort study on 968 AIS patients with APAs from January 2010 to December 2013 who were evaluated using optical platelet aggregometry (OPA). All patients received the dual APA combination of aspirin and clopidogrel or aspirin alone. We evaluated their platelet function 5 days after hospital admission using OPA. HRPR after ADP stimuli was defined as platelet aggregation of 70% or greater according to OPA after 10 μM ADP stimuli. Results: The primary endpoint was a composite of all causes of death, myocardial infarction, and stroke at the 1-year follow-up. The secondary endpoints were each component of the primary endpoint. The event rate of primary endpoint was 11.3% (109/968). Its rate was significantly higher in the patients with HRPR (16.7%) than in those without (9.7%). HPRP was independently associated with the primary endpoint (OR=1.97, CI 1.22 to 3.18, p<0.01). According to the AIS subtype, the presence of HRPR was independently significant for the occurrence of the primary endpoint in the large artery atherosclerosis (LAA) subtype only (OR=2.26, CI 1.15 to 4.45, P=0.02). Conclusions: In this study, the presence of HRPR after ADP stimuli is associated with a poor long-term outcome after acute ischemic stroke. In particular, the influence of this factor might be more prominent in LAA compared with other types of AIS.

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Polymorphism of the complement 5 gene is associated with large artery atherosclerosis stroke in Chinese patients

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20160139 ◽

2016 ◽

Vol 74 (11) ◽

pp. 881-886 ◽

Cited By ~ 2

Author(s):

Hui Wu ◽

Yingfeng Weng ◽

Lan Zheng ◽

Huanyin Li ◽

Qi Gong ◽

...

Keyword(s):

Ischemic Stroke ◽

Chinese Patients ◽

Large Artery ◽

Nucleotide Polymorphism ◽

Term Outcome ◽

Single Nucleotide ◽

Long Term Outcome ◽

Risk Predictors ◽

The Complement System

ABSTRACT The complement system has been confirmed to play an increasingly important role in ischemic stroke (IS). This study aimed to determine whether the single-nucleotide polymorphism of the complement 5 (C5) gene independently influences the occurrence, severity, and long-term outcome of IS in Chinese patients. Methods C5 rs17611 genetic variants were investigated in 494 IS patients and 330 control individuals .Ischemic stroke was classiﬁed into subtypes and patients were assessed 90 days post-stroke with the modified Rankin Scale to determine stroke outcome. Results The presence of C5 polymorphism was associated with the incidence of large artery atherosclerosis (LAA)-subtype IS (n =2 00; p = 0.031), which even persisted after adjustment for covariates (OR = 1.518; 95%CI = 1.093–2.018; p = 0.013). However, no association was found between genotypes and the severity and outcome of stroke (p = 0.978; p = 0.296). Conclusions The C5 polymorphism might contribute to the risk of LAA-subtype IS independently of other known risk predictors.

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Functional Inflammatory Genotypes in Ischemic Stroke: Could We Use Them to Predict Age of Onset and Long-Term Outcome?

Stroke Research and Treatment ◽

10.4061/2011/792923 ◽

2011 ◽

Vol 2011 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Stella Marousi ◽

Anna Antonacopoulou ◽

Haralambos Kalofonos ◽

Panagiotis Papathanasopoulos ◽

Marina Karakantza ◽

...

Keyword(s):

Ischemic Stroke ◽

Cox Regression ◽

Age Of Onset ◽

Adverse Outcome ◽

Nucleotide Polymorphisms ◽

Term Outcome ◽

Single Nucleotide ◽

Long Term Outcome ◽

Tnf Α

Functional single-nucleotide polymorphisms (SNPs) of inflammatory cytokines have been previously related to the occurrence of an ischemic stroke (IS). We investigated whether five functional SNPs (i.e., TNF-α-308G>A, IL6-174G>C, IL12B 1188A>C, IL4-589C>T, and IL10-1082G>A) might be associated with the age of onset and 6-month outcome of an acute IS. A probe-free real-time PCR methodology was used to genotype 145 consecutively admitted cases with a first-ever IS. Simple Kaplan-Mayer and adjusted Cox regression analyses showed no association between inflammatory genotypes and the age of IS onset. IL6-174G>C, IL12B 1188A>C, IL4-589C>T, and IL10-1082G>A were not found to significantly contribute to the long-term outcome of the disease. However, carriage of the TNF-α-308 GG genotype was significantly associated with reduced odds for an adverse outcome. Larger studies are needed to confirm our results.

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