title: Coexisting small vessel disease predicts poor long-term outcome in stroke patients with intracranial large artery atherosclerosis.
abstract: OBJECTIVE
  Until now, limited data are available about the potential effect of coexisting small vessel disease (SVD) on the long-term outcome of stroke patients with intracranial large artery atherosclerosis (ILAA).
  
  
  METHODS
  A prospective study was performed on 293 patients with symptomatic ILAA, who were divided into 4 groups (group I, single intracranial large artery atherosclerosis (SILAA) without SVD; group II, multiple intracranial large arteries atherosclerosis (MILAA) without SVD; group III, SILAA with SVD; group IV, MILAA with SVD) and followed up for recurrent stroke or death.
  
  
  RESULTS
  The 3-year cumulative risks of recurrent stroke were 18% for SILAA without SVD, 38% for MILAA without SVD, 21% for SILAA with SVD and 34% for MILAA with SVD. The 3-year cumulative risks of death were 6, 7, 20 and 22%, respectively. Compared with SILAA without SVD, more recurrent stroke occurred in MILAA without SVD (log-rank 3.83; p = 0.050) and MILAA with SVD (log-rank 7.79; p = 0.014), and the higher risk of death (log-rank 9.472; p = 0.002) was found in group MILAA with SVD. A Cox proportional-hazards regression model showed that MILAA with SVD may be a predictor of recurrent stroke (hazard ratio 2.001; 95% CI 1.108-3.934; p = 0.044), and a borderline predictor for death (hazard ratio 3.180; 95% CI 0.895-10.987; p = 0.073).
  
  
  CONCLUSIONS
  Coexisting SVD is very common and may predict poor outcome in stroke patients with symptomatic ILAA.
authors: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors: Jian Hui
authors: JH
authors: Fu
authors: Yang Kun
authors: YK
authors: Chen
authors: Xiang Yan
authors: XY
authors: Chen
authors: Vincent
authors: V
authors: Mok
authors: Ka Sing
authors: KS
authors: Wong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000098:blood supply*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000453:epidemiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D055806:Microvessels; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis*; D014652:Vascular Diseases / Q000453:epidemiology*