title: Factors related to progression of middle cerebral artery stenosis determined using transcranial Doppler ultrasonograhy.
abstract: Atherosclerosis plays an important role in ischemic stroke. We conducted this prospective study to determine significant factors related to progression of middle cerebral artery (MCA) stenosis. We studied 103 patients with MCA stenosis using transcranial Doppler (TCD) and re-evaluated the TCD results at 6 months after the initial investigation and measured platelet aggregability for adenosine diphosphate (ADP) or arachidonic acid (AA). After 6 months, 13 (12.6%) patients showed worsening, whereas 90 were stationary or showed regression upon TCD examination. In a univariate analysis, the history of ischemic stroke (P=0.023), the presence of significant carotid stenosis (P=0.027), the prescription of aspirin only (P=0.046), the grade of stenosis in the MRA (P=0.0048), and the platelet aggregability for ADP (P=0.015) were significantly associated with the progression of MCA stenosis. After multiple logistic regression analysis, the grades of stenosis and platelet aggregability for ADP were independent factors related to the progression of MCA stenosis. In this study, the grade of MCA stenosis on angiography might be an important factor to predict the progression upon serial TCD examination. Also, the extent of inhibition of platelet activation could be a possible role to determine on the progression of MCA stenosis.
authors.affiliation: Department of Neurology, College of Medicine, Dong-A University Hospital, 1,3 Ga, Dongdaeshin-Dong, Seo-Gu, 602-715 Busan, Korea.
authors.forename: Hyung-Won
authors.initials: HW
authors.lastname: Jeon
authors.forename: Jae-Kwan
authors.initials: JK
authors.lastname: Cha
mesh_terms: D000244:Adenosine Diphosphate; D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D002533:Cerebral Angiography / Q000379:methods; D000077144:Clopidogrel; D003251:Constriction, Pathologic; D018450:Disease Progression; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000097:blood / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D016015:Logistic Models; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D010979:Platelet Function Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D017585:Ultrasonography, Doppler, Transcranial
chemical_list: D010975:Platelet Aggregation Inhibitors; D000244:Adenosine Diphosphate; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin