中风亚型与血管内治疗效果之间的关系:ANGEL-ASPECT 试验的事后分析

IF 4.4 1区 医学 Q1 CLINICAL NEUROLOGY Stroke and Vascular Neurology Pub Date : 2024-09-17 DOI:10.1136/svn-2024-003115
Da Lu, Raynald ­, Dapeng Sun, Na Zheng, Bohao Zhang, Leilei Luo, Sifei Wang, Sihu Pan, Yuchao Dou, Mengxing Wang, Yuesong Pan, Xiaochuan Huo, Zhongrong Miao, Ming Wei
{"title":"中风亚型与血管内治疗效果之间的关系:ANGEL-ASPECT 试验的事后分析","authors":"Da Lu, Raynald ­, Dapeng Sun, Na Zheng, Bohao Zhang, Leilei Luo, Sifei Wang, Sihu Pan, Yuchao Dou, Mengxing Wang, Yuesong Pan, Xiaochuan Huo, Zhongrong Miao, Ming Wei","doi":"10.1136/svn-2024-003115","DOIUrl":null,"url":null,"abstract":"Objectives Our study aims to examine the value of endovascular therapy (EVT) and its comparison to medical management (MM) in ischaemic stroke patients accompanied by large artery atherosclerosis (LAA) and non-LAA Methods modified Rankin scale score (mRS) was evaluated at 90 days post the stroke attack and was considered as the primary outcome. Other outcomes measured in this study included score changes of 0–2 and 0–3 on the mRS. The occurrence of symptomatic intracranial haemorrhage at 24 hours after EVT was also measured as a safety endpoint. Logistic regression analysis was used to determine the associations. Results In the LAA group, no significant difference in mRS at 90-day (median IQR 3 (2–5) vs 4 (3–4), 95% CI 0.53 to 2.00, p=0.924), mRS 0–2 and mRS 0–3 was observed between EVT and MM groups. However, in the non-LAA group, patients who underwent EVT had lower 90-day mRS scores (4 (2–5) vs 4 (3–5), generalised OR 1.47, 95% CI 1.14 to 1.88, p<0.001). No interaction effect on the primary outcomes between treatment options and aetiology. More intracranial haemorrhage events within 48 hours were identified in the EVT group for both LAA and non-LAA cohorts (LAA: 40.98% vs 9.62%, relative risk (RR) 4.26, 95% CI 1.76 to 10.34, p<0.001; non-LAA, 52.07% vs 19.65%, RR 2.65, 95% CI 1.90 to 3.70, respectively). Conclusions For large infarcts, EVT may be more effective than MM for patients with non-LAA aetiology, but not for those with LAA stroke. As no interaction effect was found, the benefit of EVT compared with MM did not vary by stroke subtypes. Data are available on reasonable request.","PeriodicalId":22021,"journal":{"name":"Stroke and Vascular Neurology","volume":null,"pages":null},"PeriodicalIF":4.4000,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association between stroke subtypes and outcomes of endovascular therapy: a post-hoc analysis of the ANGEL-ASPECT Trial\",\"authors\":\"Da Lu, Raynald ­, Dapeng Sun, Na Zheng, Bohao Zhang, Leilei Luo, Sifei Wang, Sihu Pan, Yuchao Dou, Mengxing Wang, Yuesong Pan, Xiaochuan Huo, Zhongrong Miao, Ming Wei\",\"doi\":\"10.1136/svn-2024-003115\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objectives Our study aims to examine the value of endovascular therapy (EVT) and its comparison to medical management (MM) in ischaemic stroke patients accompanied by large artery atherosclerosis (LAA) and non-LAA Methods modified Rankin scale score (mRS) was evaluated at 90 days post the stroke attack and was considered as the primary outcome. Other outcomes measured in this study included score changes of 0–2 and 0–3 on the mRS. The occurrence of symptomatic intracranial haemorrhage at 24 hours after EVT was also measured as a safety endpoint. Logistic regression analysis was used to determine the associations. Results In the LAA group, no significant difference in mRS at 90-day (median IQR 3 (2–5) vs 4 (3–4), 95% CI 0.53 to 2.00, p=0.924), mRS 0–2 and mRS 0–3 was observed between EVT and MM groups. However, in the non-LAA group, patients who underwent EVT had lower 90-day mRS scores (4 (2–5) vs 4 (3–5), generalised OR 1.47, 95% CI 1.14 to 1.88, p<0.001). No interaction effect on the primary outcomes between treatment options and aetiology. More intracranial haemorrhage events within 48 hours were identified in the EVT group for both LAA and non-LAA cohorts (LAA: 40.98% vs 9.62%, relative risk (RR) 4.26, 95% CI 1.76 to 10.34, p<0.001; non-LAA, 52.07% vs 19.65%, RR 2.65, 95% CI 1.90 to 3.70, respectively). Conclusions For large infarcts, EVT may be more effective than MM for patients with non-LAA aetiology, but not for those with LAA stroke. As no interaction effect was found, the benefit of EVT compared with MM did not vary by stroke subtypes. Data are available on reasonable request.\",\"PeriodicalId\":22021,\"journal\":{\"name\":\"Stroke and Vascular Neurology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.4000,\"publicationDate\":\"2024-09-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Stroke and Vascular Neurology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/svn-2024-003115\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Stroke and Vascular Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/svn-2024-003115","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

摘要

目的 我们的研究旨在探讨血管内治疗(EVT)的价值,以及它与药物治疗(MM)在伴有大动脉粥样硬化(LAA)和非大动脉粥样硬化的缺血性中风患者中的比较方法。本研究测量的其他结果包括 mRS 评分 0-2 分和 0-3 分的变化。EVT术后24小时内出现无症状颅内出血的情况也作为安全终点进行测量。采用逻辑回归分析确定相关性。结果 在LAA组中,EVT组和MM组在90天时的mRS(中位数IQR 3 (2-5) vs 4 (3-4),95% CI 0.53 to 2.00,p=0.924)、mRS 0-2和mRS 0-3方面无明显差异。然而,在非LAA组中,接受EVT的患者90天mRS评分较低(4 (2-5) vs 4 (3-5),广义OR 1.47,95% CI 1.14 to 1.88,p<0.001)。治疗方案与病因对主要结果无交互影响。在LAA和非LAA队列中,EVT组在48小时内发现了更多的颅内出血事件(LAA:40.98% vs 9.62%,相对风险(RR)4.26,95% CI 1.76至10.34,p<0.001;非LAA:52.07% vs 19.65%,RR 2.65,95% CI 1.90至3.70)。结论 对于大面积脑梗死,对于非LAA病因的患者,EVT可能比MM更有效,但对于LAA脑卒中患者则不然。由于未发现交互效应,EVT 与 MM 相比的获益并不因卒中亚型而异。如有合理要求,可提供相关数据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Association between stroke subtypes and outcomes of endovascular therapy: a post-hoc analysis of the ANGEL-ASPECT Trial
Objectives Our study aims to examine the value of endovascular therapy (EVT) and its comparison to medical management (MM) in ischaemic stroke patients accompanied by large artery atherosclerosis (LAA) and non-LAA Methods modified Rankin scale score (mRS) was evaluated at 90 days post the stroke attack and was considered as the primary outcome. Other outcomes measured in this study included score changes of 0–2 and 0–3 on the mRS. The occurrence of symptomatic intracranial haemorrhage at 24 hours after EVT was also measured as a safety endpoint. Logistic regression analysis was used to determine the associations. Results In the LAA group, no significant difference in mRS at 90-day (median IQR 3 (2–5) vs 4 (3–4), 95% CI 0.53 to 2.00, p=0.924), mRS 0–2 and mRS 0–3 was observed between EVT and MM groups. However, in the non-LAA group, patients who underwent EVT had lower 90-day mRS scores (4 (2–5) vs 4 (3–5), generalised OR 1.47, 95% CI 1.14 to 1.88, p<0.001). No interaction effect on the primary outcomes between treatment options and aetiology. More intracranial haemorrhage events within 48 hours were identified in the EVT group for both LAA and non-LAA cohorts (LAA: 40.98% vs 9.62%, relative risk (RR) 4.26, 95% CI 1.76 to 10.34, p<0.001; non-LAA, 52.07% vs 19.65%, RR 2.65, 95% CI 1.90 to 3.70, respectively). Conclusions For large infarcts, EVT may be more effective than MM for patients with non-LAA aetiology, but not for those with LAA stroke. As no interaction effect was found, the benefit of EVT compared with MM did not vary by stroke subtypes. Data are available on reasonable request.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Stroke and Vascular Neurology
Stroke and Vascular Neurology Medicine-Cardiology and Cardiovascular Medicine
CiteScore
11.20
自引率
1.70%
发文量
63
审稿时长
15 weeks
期刊介绍: Stroke and Vascular Neurology (SVN) is the official journal of the Chinese Stroke Association. Supported by a team of renowned Editors, and fully Open Access, the journal encourages debate on controversial techniques, issues on health policy and social medicine.
期刊最新文献
Association between stroke subtypes and outcomes of endovascular therapy: a post-hoc analysis of the ANGEL-ASPECT Trial Optimal duration of dual antiplatelet therapy for minor stroke within 72 hours of symptom onset: a prospective cohort study Association between ASPECTS region of infarction and clinical outcome in non-acute large vessel occlusion ischaemic stroke after endovascular recanalisation Sex differences in the epidemiology of spontaneous and traumatic cervical artery dissections miR-19-3p/GRSF1/COX1 axis attenuates early brain injury via maintaining mitochondrial function after subarachnoid haemorrhage
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1