Classification And Future Prognosis Of Ischemic Stroke Subtypes According To ASCO Criteria

Objective: To analyze the endpoint events of different subtypes using the ASCOclassification for etiological diagnoses of ischemic stroke patients; To evaluate theagreement of ASCO criteria.Methods: That research was a retrospective study, all patients hospitalized with acuteischemic stroke were selected from Department of Neurology, the First affiliatedhospital of Ji Nan University from January2006to December2007. Collected clinicaldata of all patients, including the results of CT or MR, TCD, ECG and the One-yearfollow-up records. All patients were classified according to ASCO criteria. We usedthe SPSS program version13.0for statistical data analysis. The subtype of mixedetiology of the ASCO criteria defined as in the cause of A, S, C and O, at least twokinds of those, the grade was1or2.Results: A total of296patients with acute ischemic stroke were selected, WhenASCO grades1to3were applied, atherosclerosis(A) was identified as the cause in78.04%of patients, small artery disease(S) in83.11%, cardiac disease(C) in10.13%,and other causes(O) in2.70%. Application of ASCO grade1indicated evidence, Swas the highest (38.85%),the next was A (35.81%), C (8.78%),and O(0.68%). A totalof32cases had mixed etiology, accounting for10.81%. Agreement foratherosclerotic，small artery disease，cardiac disease and other causes etiology of theASCO criteria was separately good (κ values=0.75,0.76,0.9and1.0).In the cases selected,271patients had the One-year follow-up records. A total of45cases had composite endpoint events, which was16.61%of the total follow-upcases. The rat of composite endpoint events of A1was more higher than the S1（27.36%VS.8.57%，χ2=12.20，p=0.000），and the rat of C1was high, comparedwith S1（34.78%VS.8.57%，χ2=12.20，p=0.001）.The rat of patients which hadmixed etiology was18.75%.Conclusions:1、 Based on the ASCO criteria, with grade1or grade1to3, the most frequentsubtype was S, followed by A, C, and O. 2、 The ASCO criteria can be used to research the ischemic stroke of mixedetiology.3、 For the rat of composite endpoint events, the highest was C1, followed by A1,mixed etiology, S1, and O1.4、 The ASCO criteria had good reliability and can be applied to the clinical studyof ischemic stroke.