title: Atherosclerotic burden and early mortality in acute ischemic stroke.
abstract: BACKGROUND
  The influence that previous clinical expressions of systemic atherosclerosis may have on evolution and early mortality in patients with acute ischemic stroke is not known.
  
  
  OBJECTIVE
  To evaluate the influence that atherosclerotic burden (ATB), assessed by a simple clinical scale, has on the 30-day mortality in patients with first-ever ischemic stroke.
  
  
  METHODS
  Retrospective review of case series from a prospective stroke record. An ATB score ranging from 0 to 2 was created using the history of ischemic heart disease and peripheral arterial disease. The impact of this score on the 30-day mortality was analyzed by multivariate regression analysis.
  
  
  METHODS
  Tertiary university hospital. Patients A total of 1527 patients with first-ever ischemic stroke. Main Outcome Measure Thirty-day mortality.
  
  
  RESULTS
  The 30-day mortality rate was 13.8%. Multivariate regression analysis showed an association between the ATB score and the 30-day mortality (P<.001). Comparing patients having no previous ATB with those with an ATB score of 1 or 2, the odds ratio (OR) for 30-day mortality increased from 1.71 (95% confidence interval [CI], 1.06-2.75) for patients with an ATB score of 1 to 5.90 (95% CI, 2.48-14.04) for those with an ATB score of 2. Age (OR, 1.05; 95% CI, 1.03-1.08), National Institutes of Health Stroke Scale score at admission (OR, 1.22; 95% CI, 1.18-1.25), atrial fibrillation (OR, 1.61; 95% CI, 1.10-2.35), hyperlipidemia as protector (OR, 0.39; 95% CI, 0.25-0.60), and glycemia at admission (OR, 1.07; 95% CI, 1.02-1.12) were also predictors of 30-day mortality.
  
  
  CONCLUSIONS
  Previous symptomatic atherosclerotic disease evaluated by a simple clinical score is an independent predictor of early mortality in patients with first-ever ischemic stroke.
authors.affiliation: Unitat d'Ictus, Servei de Neurologia, Hospital Universitari del Mar, IMIM - Hospital del Mar, Barcelona, Spain. 35826@imas.imim.es
authors.forename: Jaume
authors.initials: J
authors.lastname: Roquer
authors.forename: Angel
authors.initials: A
authors.lastname: Ois
authors.forename: Ana
authors.initials: A
authors.lastname: Rodríguez-Campello
authors.forename: Meritxell
authors.initials: M
authors.lastname: Gomis
authors.forename: Elvira
authors.initials: E
authors.lastname: Munteis
authors.forename: Jordi
authors.initials: J
authors.lastname: Jiménez-Conde
authors.forename: Elisa
authors.initials: E
authors.lastname: Cuadrado-Godia
authors.forename: José E
authors.initials: JE
authors.lastname: Martínez-Rodríguez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000209:etiology*; D002545:Brain Ischemia / Q000150:complications* / Q000401:mortality*; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D020521:Stroke / Q000150:complications* / Q000453:epidemiology / Q000401:mortality*