First-ever ischemic stroke in elderly patients: predictors of functional outcome following carotid artery stenting

Chih-Ming Lin,1,2 Yu-Jun Chang,3 Chi-Kuang Liu,4 Cheng-Sheng Yu,5 Henry Horng-Shing Lu5 1Department of Neurology, Stroke Center, Changhua Christian Hospital, Changhua, 2Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, 3Epidemiology and Biostatistics Center,...

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Autores principales:	Lin CM, Chang YJ, Liu CK, Yu CS, Lu HH
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	modified Rankin scale resistance index Barthel Index common carotid artery cerebral blood volume ratio Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/f36998100fb44ebd8982c7b528e8e884
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spelling	oai:doaj.org-article:f36998100fb44ebd8982c7b528e8e8842021-12-02T06:56:05ZFirst-ever ischemic stroke in elderly patients: predictors of functional outcome following carotid artery stenting1178-1998https://doaj.org/article/f36998100fb44ebd8982c7b528e8e8842016-07-01T00:00:00Zhttps://www.dovepress.com/first-ever-ischemic-stroke-in-elderly-patients-predictors-of-functiona-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Chih-Ming Lin,1,2 Yu-Jun Chang,3 Chi-Kuang Liu,4 Cheng-Sheng Yu,5 Henry Horng-Shing Lu5 1Department of Neurology, Stroke Center, Changhua Christian Hospital, Changhua, 2Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, 3Epidemiology and Biostatistics Center, Changhua Christian Hospital, Changhua, 4Department of Medical Imaging, Changhua Christian Hospital, Changhua, 5Institute of Statistics and Big Data Research Center, National Chiao Tung University, Hsinchu, Taiwan Abstract: Age is an important risk factor for stroke, and carotid artery stenosis is the primary cause of first-ever ischemic stroke. Timely intervention with stenting procedures can effectively prevent secondary stroke; however, the impact of stenting on various periprocedural physical functionalities has never been thoroughly investigated. The primary aim of this study was to investigate whether prestenting characteristics were associated with long-term functional outcomes in patients presenting with first-ever ischemic stroke. The secondary aim was to investigate whether patient age was an important factor in outcomes following stenting, measured by the modified Rankin scale (mRS). In total, 144 consecutive patients with first-ever ischemic stroke who underwent carotid artery stenting from January 2010 to November 2014 were included. Clinical data were obtained by review of medical records. The Barthel index (BI) and mRS were used to assess disability before stenting and at 12-month follow-up. In total, 72/144 patients showed improvement (mRS[+]), 71 showed stationary and one showed deterioration in condition (mRS[-]). The prestenting parameters, ratio of cerebral blood volume (1.41 vs 1.2 for mRS[-] vs mRS[+]), BI (75 vs 85), and high-sensitivity C-reactive protein (hsCRP 5.0 vs 3.99), differed significantly between the two outcome groups (P<0.05). The internal carotid artery/common carotid artery ratio (P=0.011), BI (P=0.019), ipsilateral internal carotid artery resistance index (P=0.003), and HbA1c (P=0.039) were all factors significantly associated with patient age group. There was no significant association between age and poststenting outcome measured by mRS with 57% of patients in the ≥75 years age group showing mRS(-) and 43% showing mRS(+) (P=0.371). Our findings indicate that in our elderly patient series, carotid artery stenting may benefit a significant proportion of carotid stenotic patients regardless of age. Ratio of cerebral blood volume, BI, and admission hsCRP could serve as important predictors of mRS improvement and may facilitate differentiation of patients at baseline. Keywords: modified Rankin scale, resistance index, Barthel index, common carotid artery, cerebral blood volume ratioLin CMChang YJLiu CKYu CSLu HHDove Medical Pressarticlemodified Rankin scaleresistance indexBarthel Indexcommon carotid arterycerebral blood volume ratioGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 11, Pp 985-995 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	modified Rankin scale resistance index Barthel Index common carotid artery cerebral blood volume ratio Geriatrics RC952-954.6
spellingShingle	modified Rankin scale resistance index Barthel Index common carotid artery cerebral blood volume ratio Geriatrics RC952-954.6 Lin CM Chang YJ Liu CK Yu CS Lu HH First-ever ischemic stroke in elderly patients: predictors of functional outcome following carotid artery stenting
description	Chih-Ming Lin,1,2 Yu-Jun Chang,3 Chi-Kuang Liu,4 Cheng-Sheng Yu,5 Henry Horng-Shing Lu5 1Department of Neurology, Stroke Center, Changhua Christian Hospital, Changhua, 2Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, 3Epidemiology and Biostatistics Center, Changhua Christian Hospital, Changhua, 4Department of Medical Imaging, Changhua Christian Hospital, Changhua, 5Institute of Statistics and Big Data Research Center, National Chiao Tung University, Hsinchu, Taiwan Abstract: Age is an important risk factor for stroke, and carotid artery stenosis is the primary cause of first-ever ischemic stroke. Timely intervention with stenting procedures can effectively prevent secondary stroke; however, the impact of stenting on various periprocedural physical functionalities has never been thoroughly investigated. The primary aim of this study was to investigate whether prestenting characteristics were associated with long-term functional outcomes in patients presenting with first-ever ischemic stroke. The secondary aim was to investigate whether patient age was an important factor in outcomes following stenting, measured by the modified Rankin scale (mRS). In total, 144 consecutive patients with first-ever ischemic stroke who underwent carotid artery stenting from January 2010 to November 2014 were included. Clinical data were obtained by review of medical records. The Barthel index (BI) and mRS were used to assess disability before stenting and at 12-month follow-up. In total, 72/144 patients showed improvement (mRS[+]), 71 showed stationary and one showed deterioration in condition (mRS[-]). The prestenting parameters, ratio of cerebral blood volume (1.41 vs 1.2 for mRS[-] vs mRS[+]), BI (75 vs 85), and high-sensitivity C-reactive protein (hsCRP 5.0 vs 3.99), differed significantly between the two outcome groups (P<0.05). The internal carotid artery/common carotid artery ratio (P=0.011), BI (P=0.019), ipsilateral internal carotid artery resistance index (P=0.003), and HbA1c (P=0.039) were all factors significantly associated with patient age group. There was no significant association between age and poststenting outcome measured by mRS with 57% of patients in the ≥75 years age group showing mRS(-) and 43% showing mRS(+) (P=0.371). Our findings indicate that in our elderly patient series, carotid artery stenting may benefit a significant proportion of carotid stenotic patients regardless of age. Ratio of cerebral blood volume, BI, and admission hsCRP could serve as important predictors of mRS improvement and may facilitate differentiation of patients at baseline. Keywords: modified Rankin scale, resistance index, Barthel index, common carotid artery, cerebral blood volume ratio
format	article
author	Lin CM Chang YJ Liu CK Yu CS Lu HH
author_facet	Lin CM Chang YJ Liu CK Yu CS Lu HH
author_sort	Lin CM
title	First-ever ischemic stroke in elderly patients: predictors of functional outcome following carotid artery stenting
title_short	First-ever ischemic stroke in elderly patients: predictors of functional outcome following carotid artery stenting
title_full	First-ever ischemic stroke in elderly patients: predictors of functional outcome following carotid artery stenting
title_fullStr	First-ever ischemic stroke in elderly patients: predictors of functional outcome following carotid artery stenting
title_full_unstemmed	First-ever ischemic stroke in elderly patients: predictors of functional outcome following carotid artery stenting
title_sort	first-ever ischemic stroke in elderly patients: predictors of functional outcome following carotid artery stenting
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/f36998100fb44ebd8982c7b528e8e884
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First-ever ischemic stroke in elderly patients: predictors of functional outcome following carotid artery stenting

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