Relationship Between Intracranial Carotid Artery Woodcock Calcification Score And Clinical Prognosis After Intravenous Thrombolysis In Acute Stroke Patients

Objective: Stroke is one of the diseases with high mortality and morbidity in human.Acute ischemic stroke(AIS)accounted for about 80% of all.Patients can benefit fewer from the treatment of Intravenous thrombolysis which have strict time windows restrictions(3~4.5h),and low large artery occlusion recanalization rate(13%~18%).The mortality and disability rate of AIS on the 90 days are 21% and 68%.We had already known that vascular calcification is often associated with the atherosclerosis.But it was unknown whether intracranial artery calcification affected the outcome after intravenous thrombolysis.We tried to explore the correlation between intracranial carotid artery calcification(ICAC)and outcomes after intravenous thrombolysis in AIS patients.Methods: From 2012 April to 2015 July,we analyzed consecutive data from 76 patients who were diagnosed with acute ischemic stroke and treated with intravenous thrombolysis in the Ninth People's Hospital,who received clear 5-mm-think cranial CT scanning and had been followed up at 3 month.Patients received endovascular therapies were excluded.This was a retrospective study.Two raters measured modified Woodcock score to detect ICAC.Each image on which the internal carotid arteries appeared was scored and the slice scores of bilateral carotid were summed,and eventually bilateral woodcock calcification score were used as index of ICAC.We also evaluated patients' neurological outcome(modified Rankin scale)and mortality at 3 months.We considered mRS<3 as good prognosis,while mRS?3 points as poor prognosis.We used Kappa analysis to observe the consistency in estimation of ICAC.We used logistic regression to find out whether ICAC was an independent factor of clinical outcomes after intravenous thrombolysis.Result: Of the 76 patients enrolled in the study,there were 34 female(44.7%),with a mean age of 70.1±12.6 years old.41 cases(53.9%)had good neurological outcome,and the calcification score for all cases was 3.3(0.5,6.5)(median,IQR).Logistic multiple regression analysis showed that the patient's gender,serum creatinine value,bilateral calcification score were significantly correlated with the clinical outcome after intravenous thrombolysis(P<0.05),and serum BUN was significantly correlated with mortality at 3 month after intravenous thrombolysis(P<0.05).Conclusion: The gender(female),serum creatinine level,and bilateral calcification score independently predicted poor clinical outcome at 3 month after intravenous thrombolysis in AIS patients.Serum BUN may independently predict mortality at 3 month after thrombolysis in AIS patients.