Clinical Characteristics And Prognosis Of Mild Large Atherosclerotic Cerebral Infarction

Background: Ischemic stroke is the most common type of stroke,accounting for approximately 60%-80% patients.According to the TOAST classification method,Ischemic stroke can be divided into five subtypes: large artery atherosclerosis,cardiogenic,small arterial,other causes,and unexplained types.The incidence and mortality of cerebral infarction in Large Artery Atherosclerosis(LAA)is extremely high,leads to low life quality of survivors.Based on the NIHSS score at admission,LAA cerebral infarction can be further divided into mild and non-mild subtypes.Although there are many clinical studies focusing on artery atherosclerosis cerebral infarction,the data on clinical characteristics and prognosis of patients with mild LAA subtipe are limited.Objective: To explore the clinical characteristics and prognostic factors of mild LAA cerebral infarction.Methods: Used a prospective cohort approach,from June 2017 to January2018,417 patients with LAA cerebral infarction who were hospitalized in the Department of Neurology,(First Affiliated Hospital of Henan University of Science and Technology)were enrolled in our study.The diagnosis of The LAA cerebral infarction met the published consensus diagnostic criteria by American Association of Heart Association(AHA)/American Stroke Association(ASA)for ischemic stroke.According to the NIHSS scores at admission,they were further divided into mild group(NIHSS ? 3 points)and non-mild group(NIHSS ? 4 points).Clinical data at baseline and MRS,as well as relapse at 3 mouth follow-up were collected.Clinical characteristics and risk factors for short-term prognosis between the two groups were analyzed.Results: 1.Comparison of clinical features between the mild group and the non-mild group:(1)Univariate analysis showed that there are statistically significant differences(P<0.05)regarding secondary prevention of stroke(ntiplatelet therapy,statin therapy and control of vascular risk factors),Low density lipoprotein(LDL),Uric Acid(UA),degree of stenosis of the responsible vessel,pathogenesist typing,condition in progression(NIHSS increased by more than 2 points within 3days of admission),hospitalization,in-hospital complications and disability at discharge.(2)The multivariate analysis of clinical features for the two groups showed that the Secondary prevention of stroke(OR=4.033,P=0.001),LAA cerebral infarction preference to lower NIHSS group;Patients with previous history of coronary heart disease(OR=0.341,P<0.001),tending to have higher NIHSS score group.2.Analysis of factors affecting prognosis: The multivariate analysis of the prognosis of the mild group at 3 months showed that the disease progression(OR=76.93,P<0.001)and hematocrit(OR=1.082,P=0.005)were statistically significant;The multivariate analysis of the prognosis of the non-mild weight group at 3 months showed that the Complications(OR = 5.388,P < 0.001),progression(OR = 5.240,P < 0.001)and vascular occlusion(OR = 2.879,P = 0.027)are statistically significant.Conclusions:1.The clinical features of Mild LAA cerebral infarction includes mild vascular stenosis,pathogenesis classification is perforating branch obstructed by carrier arter,less complications,low propensity to progress,low recurrence rate and good short-term prognosis;2.Patients with a history of secondary prevention of stroke and increased hematocrit have a higher risk of mild LAA cerebral infarction;3.Progression is detrimental factor of mild LAA cerebral infarction in 3 month follow-up.Elevated hematocrit is a Importantive factor of prognosis of mild LAA cerebral infarction in 3 month follow-up.They can be used to evaluate the shortterm prognosis of mild LAA cerebral infarction.