Objective To investigate the prevalence and prognosis of symptomatic intracranial atherosclerotic
stenoses (sICAS) among patients with ischemic stroke in Tangshan.
Methods Two hundred and thirty-one patients were included prospectively and consecutively with
acute cerebral infarction or transient ischemic attack (TIA), who underwent computed tomography
angiography (CTA). According to the distribution of the different vascular lesions, all of patients
were divided into two groups: the sICAS and the non-sICAS. Univariate and multivariate Logistic
regression were used to analyze the influence factors of the prognosis in patients with sICAS.
Results In this study, we found that the prevalence of sICAS in in-patients with ischemic stroke
was 46.8% (108/231). Univariate analyses showed that the National Institutes of Health Stroke
Scale (NIHSS) scores at admission (odds ratio [OR] 0.872, 95%confidence interval [CI] 0.775~0.980,
P =0.022), hyperhomocysteinemia (OR 0.354, 95%CI 0.132~0.984, P =0.039) and anticoagulation therapy (OR 2.597, 95%CI 1.123~6.004, P =0.026) were associated with the favorable outcomes of
sICAS patients at 6 months. Multivariate Logistic regression analyses demonstrated that the patients
with severe arterial stenoses (OR 0.182, 95%CI 0.035~0.943, P =0.042) and occlusions (OR 0.156,
95%CI 0.029~0.833, P =0.021) had more poor outcomes than those with mild arterial stenoses,
and the patients with high baseline NIHSS scores (OR 0.768, 95%CI 0.661~0.892, P =0.001) and
hyperhomocysteinemia (OR 0.177, 95%CI 0.051~0.608, P =0.006) had worse prognoses, however,
the patients receiving anticoagulative drug treatment (OR 7.714, 95%CI 2.440~24.389, P =0.001)
had better outcomes at 6 months.
Conclusion Nearly half of the in-patients with acute ischemic stroke have sICAS in Tangshan.
High NIHSS scores at admission, arterial severe stenoses/occlusions, hyperhomocysteinemia are the
predictors of unfavorable outcomes, whereas anticoagulation therapy is associated with favorable
outcomes.
