title: Risk factors and clinical outcomes associated with intracranial and extracranial atherosclerotic stenosis acute ischemic stroke.
abstract: BACKGROUND
  The aim of this study was to investigate differences in risk factors, lipid profiles, mortality, and poor functional outcome in the long term in patients who had stroke associated with intracranial and/or extracranial atherosclerotic stenosis.
  
  
  METHODS
  We consecutively and prospectively enrolled patients admitted to our hospital with acute ischemic stroke. Included patients were classified into 4 groups based on stroke subtype: noncerebral artery stenosis (NCAS), intracranial stenosis (IS), extracranial stenosis (ES), and combined intracranial and extracranial stenosis (IES). Risk factors, lipid profiles, mortality, and poor functional outcome in the long term were compared among the stenosis subtypes.
  
  
  RESULTS
  In total, 1196 patients were included in the analysis. Independent IS markers were found to be diabetes mellitus (odds ratio [OR] 1.41, 95% confidence interval [CI] 1.08-1.80, P = .01) and low-density lipoprotein (LDL) of 2.6 mmol/L or more at admission (OR 3.48, 95% CI 2.69-4.50, P < .01). Factors that increased risk for ES and IES were male gender (ES, OR 2.26, 95% CI 1.29-3.98, P < .01; IES, OR 1.65, 95% CI 1.08-2.53, P = .02), older age (ES, OR 1.03, 95% CI 1.01-1.05, P = .02; IES, OR 1.03, 95% CI 1.01-1.04, P < .01), and LDL of 2.6 mmol/L or more (ES, OR 1.74, 95% CI 1.05-2.88, P = .03; IES, OR 2.08, 95% CI 1.36-3.18, P < .01). Poor functional outcome and mortality were significantly more frequent in the IS and IES groups than in the NCAS group at 3 months and 1 year after discharge.
  
  
  CONCLUSIONS
  Patients with IS and IES were at higher risk of poor functional outcome and mortality than were patients with NCAS. Risk factors and lipid profiles differed among the stenosis subtypes. Thus, targeted strategies may need to take these differences into account to prevent or manage poor functional outcomes and mortality.
authors.affiliation: Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Sichuan Province, People's Republic of China.
authors.forename: Chunyan
authors.initials: C
authors.lastname: Lei
authors.affiliation: Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Sichuan Province, People's Republic of China; State Key Laboratory of Human Disease Biotherapy and Ministry of Education, West China Hospital, Sichuan University, Sichuan Province, People's Republic of China. Electronic address: dragonwbtxf@hotmail.com.
authors.forename: Bo
authors.initials: B
authors.lastname: Wu
authors.affiliation: Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Sichuan Province, People's Republic of China; State Key Laboratory of Human Disease Biotherapy and Ministry of Education, West China Hospital, Sichuan University, Sichuan Province, People's Republic of China.
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
authors.affiliation: Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Sichuan Province, People's Republic of China.
authors.forename: Yanchao
authors.initials: Y
authors.lastname: Chen
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D016893:Carotid Stenosis / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D016009:Chi-Square Distribution; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D020127:Recovery of Function; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D008055:Lipids
keywords: Atherosclerosis; lipid profiles; mortality; poor functional outcome; risk factors