Residual inflammatory risk predicts long-term outcomes following stenting for symptomatic intracranial atherosclerotic stenosis  

作　　者：Ying Yu Yake Lou Yuesong Pan Long Yan Weilun Fu Zhikai Hou Rongrong Cui Zhongrong Miao Yongjun Wang Xin Lou Ning Ma 

机构地区：[1]Department of Interventional Neuroradiology,Beijing Tiantan Hospital,Capital Medical University,Beijing,China [2]China National Clinical Research Center for Neurological Diseases,Beijing Tiantan Hospital,Beijing,China [3]Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing,China [4]Department of Cardiology,The Second Affiliated Hospital of Chongqing Medical University,Chongqing,China [5]Department of Neurology,Beijing Daxing District People's Hospital,Beijing,China [6]Radiology,Chinese PLA General Hospital,Beijing,China

出　　处：《Stroke & Vascular Neurology》2024年第4期407-417,共11页卒中与血管神经病学（英文）

基　　金：supported by the National Natural Science Foundation of China(contract grant number:82171894 to NM and contract grant numbers:81825012,81730048 to XL).

摘　　要：Background and purpose Residual inflammatory risk(RIR)can predict the unfavourable outcomes in patients with minor ischaemic stroke.However,the impact of preprocedural RIR on long-term outcomes in patients with symptomatic intracranial atherosclerotic stenosis(sICAS)who underwent stenting remains understudied.Methods This retrospective,single-centre cohort study evaluated consecutive patients with severe sICAS who underwent intracranial stenting.Patients were categorised into four groups based on preprocedural high-sensitivity C-reactive protein(hs-CRP)and low-density lipoprotein cholesterol(LDL-C):residual cholesterol inflammatory risk(RCIR,hs-CRP≥3 mg/L and LDL-C≥2.6 mmol/L),RIR(hs-CRP≥3 mg/L and LDL-C<2.6 mmol/L),residual cholesterol risk(RCR,hs-CRP<3 mg/L and LDL-C≥2.6 mmol/L)and no residual risk(NRR,hs-CRP<3 mg/L and LDL-C<2.6 mmol/L).The long-term clinical outcomes included recurrent ischaemic stroke and death.The long-term imaging outcomes consisted of in-stent restenosis(ISR)and symptomatic ISR(sISR)after stenting.Results In this study,952 patients were included,with 751(78.9%)being male.Forty-six cases were categorised into the RCIR group,211 into the RIR group,107 into the RCR group and 588 into the NRR group.Patients with RCIR(adjusted HR 6.163;95%CI 2.603 to 14.589;p<0.001)and RIR(adjusted HR 2.205;95%CI 1.294 to 3.757;p=0.004)had higher risks of recurrent ischaemic stroke than those with NRR during the 54 months of median follow-up time.Patients with RCIR(adjusted HR 3.604;95%CI 1.431 to 9.072;p=0.007)were more likely to occur ISR,and patients in the RIR group showed a significant increase in the risk of sISR(adjusted HR 2.402;95%CI 1.078 to 5.351;p=0.032)compared with those in the NRR group with a median follow-up time of 11.9 months.Conclusions In patients with sICAS,preprocedural RIR may predict long-term recurrent ischaemic stroke,ISR and sISR following intracranial stenting.

关 键 词：INTRACRANIAL STENOSIS SYMPTOMATIC 

分 类 号：R651.1[医药卫生—外科学]