Outcome Comparison of Endovascular Treatment for Acute Large Vessel Occlusion Due to Large Artery Atherosclerosis and Cardioembolism in the Chinese Population: Data from the ANGEL Registry

IF 3.6 3区医学 Clinical Interventions in Aging Pub Date : 2024-02-26 DOI:10.2147/cia.s442339

Guangcai Shao, Xiang Li, Meiyue Da, Xiaochuan Huo, Shuheng Zhang

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Abstract

Background and Purpose: Studies on outcome comparison after endovascular treatment (EVT) for large vessel occlusion (LVO) between large artery atherosclerosis (LAA) and cardioembolism (CE) in the Asian population are scarce. We aimed to compare the baseline characteristics and clinical outcomes after EVT for anterior circulation LVO with LAA and CE in the Chinese population.
Methods: Patients were selected from the ANGEL registry and divided into LAA and CE groups. The primary outcome was the 90-day modified Rankin Scale (mRS) 0– 2. The secondary outcomes were 90-day mRS distribution, 90-day mRS 0– 1, 90-day mRS 0– 3, and early neurological improvement. The safety outcomes included death, symptomatic intracranial hemorrhage, and any intracranial hemorrhage. We conducted logistic regression models with adjustments to compare the outcomes.
Results: A total of 632 patients were included, of whom, 488 were in the LAA group and 144 were in the CE group. No significant difference in 90-day mRS 0– 2 was observed between LAA and CE groups (55.7%vs.43.1%, odds ratio[OR] 1.19, 95% confidence interval(CI), 0.92– 1.53, P=0.190). The LAA group exhibited a higher frequency of mRS 0– 3 compared to the CE group (69.1% vs 32.6%, OR1.32, 95% CI 1.02– 1.72, P=0.038). However, the incidence of death within 90 days did not significantly differ between the LAA and CE groups (10.9%vs.24.3%, OR0.91, 95% CI0.66– 1.25, P=0.545), nor did the occurrences of symptomatic intracranial hemorrhage(SICH) (4.5%vs.9.7%,OR1.08, 95% CI 0.65– 1.78, P=0.779) or intracranial hemorrhage(ICH) (21.9%vs.30.6%, OR 0.94, 95% CI0.71– 1.25, P=0.680). Moreover, no significant disparities were detected in other outcomes between the two groups (All P> 0.05).
Conclusion: In the ANGEL registry, a higher prevalence of patients undergoing EVT for acute anterior circulation LVO with LAA was found than those with CE. However, our study revealed that the efficacy and safety of EVT remained consistent regardless of the stroke’s etiology such as LAA or CE.

Keywords: large vessel occlusion, endovascular treatment, large artery atherosclerosis, cardioembolism

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中国人群中因大动脉粥样硬化和心肌栓塞导致的急性大血管闭塞的血管内治疗效果比较：来自ANGEL注册中心的数据

背景和目的：关于亚洲人群大动脉粥样硬化（LAA）和心栓塞（CE）大血管闭塞（LVO）血管内治疗（EVT）后疗效比较的研究很少。我们旨在比较中国人群前循环 LVO 伴 LAA 和 CE EVT 的基线特征和临床结果：方法：从ANGEL登记处选取患者，分为LAA组和CE组。主要结果为90天改良Rankin量表（mRS）0- 2。次要结局为 90 天 mRS 分布、90 天 mRS 0- 1、90 天 mRS 0- 3 和早期神经功能改善。安全性结果包括死亡、症状性颅内出血和任何颅内出血。我们采用调整后的逻辑回归模型对结果进行了比较：共纳入632名患者，其中LAA组488人，CE组144人。LAA 组和 CE 组 90 天 mRS 0- 2 无明显差异（55.7%vs.43.1%，比值比[OR]1.19，95% 置信区间(CI)，0.92- 1.53，P=0.190）。与CE组相比，LAA组出现mRS 0- 3的频率更高（69.1%对32.6%，OR1.32，95% CI 1.02- 1.72，P=0.038）。然而，LAA 组和 CE 组 90 天内死亡的发生率没有明显差异（10.9% 对 24.3%，OR0.91，95% CI0.66-1.25，P=0.545），症状性颅内出血（SICH）的发生率也没有明显差异（4.5% 对 9..7%，OR1.08，95% CI 0.65-1.78，P=0.779）或颅内出血（ICH）（21.9% 对 30.6%，OR 0.94，95% CI 0.71-1.25，P=0.680）。此外，两组患者在其他结果方面没有发现明显差异（所有P> 0.05）：结论：在ANGEL登记中发现，因急性前循环LVO合并LAA而接受EVT治疗的患者发病率高于合并CE的患者。然而，我们的研究显示，无论卒中的病因是 LAA 还是 CE，EVT 的有效性和安全性都是一致的。

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来源期刊

Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-

CiteScore

6.20

自引率

2.80%

发文量

193

期刊介绍： Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.