title: Risk Factor Stratification for Intracranial Stenosis in Taiwanese Patients With Cervicocerebral Stenosis.
abstract: BACKGROUND
  Intracranial stenosis (ICS) is a major determinant of ischemic stroke in Asians. We determined the clinical significance of different risk factors and the role of ICS in Taiwanese patients with varied distributions of cervicocerebral stenosis.
  
  
  RESULTS
  Presence of extracranial carotid stenosis (ECS, ≥70%) and ICS (>50%) was examined in 13 539 patients using ultrasonography and magnetic resonance angiography, respectively. Seven hundred thirty-three patients with non-ECS/ICS (n=372), isolated ICS (n=112), isolated ECS (n=121), or combined ECS/ICS (CEIS, n=128) were selected. Prevalence of ischemic stroke in each group was compared, and risk factors for stenosis were determined. The area under the receiver operating characteristic curve for each risk factor was calculated. Prevalence of ischemic stroke was highest in patients with CEIS (odds ratio 15.86; P<0.001), followed in decreasing order by those with isolated ICS (odds ratio 7.16; P<0.001), isolated ECS (odds ratio 1.77; P=0.011), and non-ECS/ICS. Multivariate logistic regression analysis revealed that hypertension, coronary artery disease, and smoking were risk factors for isolated ECS; hypertension, diabetes mellitus, coronary artery disease, and smoking were risk factors for isolated ICS; and diabetes mellitus, coronary artery disease, and smoking were risk factors for CEIS. Smoking, diabetes mellitus, and coronary artery disease were the greatest contributors to CEIS, isolated ICS, and isolated ECS, respectively.
  
  
  CONCLUSIONS
  CEIS was associated with higher odds of ischemic stroke compared with isolated ICS and isolated ECS. Smoking and diabetes mellitus, major determinants of CEIS and isolated ICS, should be targeted in therapeutic strategies to reduce the risk of ischemic stroke.
authors.affiliation: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Y.F.S., C.L.T., G.S.P.) Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Y.F.S., J.T.L., C.L.T., C.C.L., Y.D.H., J.C.L., G.S.P.).
authors.forename: Yueh-Feng
authors.initials: YF
authors.lastname: Sung
authors.affiliation: Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Y.F.S., J.T.L., C.L.T., C.C.L., Y.D.H., J.C.L., G.S.P.).
authors.forename: Jiunn-Tay
authors.initials: JT
authors.lastname: Lee
authors.affiliation: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Y.F.S., C.L.T., G.S.P.) Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Y.F.S., J.T.L., C.L.T., C.C.L., Y.D.H., J.C.L., G.S.P.).
authors.forename: Chia-Lin
authors.initials: CL
authors.lastname: Tsai
authors.affiliation: Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Y.F.S., J.T.L., C.L.T., C.C.L., Y.D.H., J.C.L., G.S.P.).
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Y.F.S., J.T.L., C.L.T., C.C.L., Y.D.H., J.C.L., G.S.P.).
authors.forename: Yaw-Don
authors.initials: YD
authors.lastname: Hsu
authors.affiliation: Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Y.F.S., J.T.L., C.L.T., C.C.L., Y.D.H., J.C.L., G.S.P.).
authors.forename: Jiann-Chyun
authors.initials: JC
authors.lastname: Lin
authors.affiliation: Department of Epidemiology, School of Public Health, National Defense Medical Center, Taipei, Taiwan (C.M.C.).
authors.forename: Chi-Ming
authors.initials: CM
authors.lastname: Chu
authors.affiliation: Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan (Y.F.S., C.L.T., G.S.P.) Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Y.F.S., J.T.L., C.L.T., C.C.L., Y.D.H., J.C.L., G.S.P.) Section of Neurology, Department of Internal Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu County, Taiwan (G.S.P.).
authors.forename: Giia-Sheun
authors.initials: GS
authors.lastname: Peng
mesh_terms: D000367:Age Factors; D000368:Aged; D002545:Brain Ischemia / Q000453:epidemiology / Q000209:etiology; D016893:Carotid Stenosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D018810:Magnetic Resonance Angiography; D008297:Male; D015995:Prevalence; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology; D013624:Taiwan; D014463:Ultrasonography
keywords: atherosclerosis; carotid arteries; risk factors; stenosis; stroke