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Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 2024 Jun 18;33(8):107783. doi: 10.1016/j.jstrokecerebrovasdis.2024.107783 Q32.02024

Long-term outcomes among ischemic stroke TOAST subtypes: A 12-year Cohort study in China

中国缺血性卒中TOAST分型患者的长期预后——一项平均12年随访的队列研究 翻译改进

Jing Yang  1, Chenyao Wu  2, Yu Jin  1, Meijing Hu  1, Yidie Lin  1, Qiang Yao  1, Cairong Zhu  3

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作者单位

  • 1 Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University 610041, PR China.
  • 2 Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University 610041, PR China; Public Health Center, Tianfu New Area Disease Prevention and Control Center, Sichuan, PR China.
  • 3 Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University 610041, PR China. Electronic address: cairong.zhu@hotmail.com.

    • DOI: 10.1016/j.jstrokecerebrovasdis.2024.107783 PMID: 38896973

    摘要 Ai翻译

    Background: Disparities in short-term ischemic stroke (IS) prognosis among Trial of Org 10172 in Acute Stroke Treatment (TOAST) subtypes were observed. Notably, little is known about the long-term prognosis of different subtypes in China. We aim to investigate the long-term outcome in IS patients and try to explore the potential interactive effects between IS subtypes and antithrombotic therapy.

    Methods: This is a prospective cohort of stroke survivors. Patients diagnosed with first-ever IS at the Department of Neurology, West China Hospital, Sichuan University from January 2010 to December 2019 were recruited. They were followed until September 2022 to assess recurrence, mortality, and functional recovery. The multivariate Fine-Gray model assessed stroke recurrence, while Cox regression estimated hazard ratios. Modified Rankin Scale scores(mRS) were analyzed using the generalized linear mixed effects model.

    Results: At baseline, 589 of 950 participants (62.00 %) were male. The longest follow-up was 150 months, the shortest was 1.5 months, and the median follow-up was 81.0 months. Cardio-embolism (CE) bore the highest mortality risk compared to large artery atherosclerosis (LAA) (HR=4.43,95 %CI 1.61-12.23). Among survivors on anticoagulant therapy, CE exhibited a reduced risk of mortality (HR = 0.18, 95 % CI 0.04-0.80). In function recovery, small artery occlusion (SAO) demonstrated more favorable prognostic outcomes (β=-2.08, P<0.01, OR=0.13,95 %CI 0.03-0.47). Among survivors taking antiplatelet drugs, SAO demonstrated a slower pace of functional recovery compared to LAA (β=1.39, P=0.05, OR=3.99,95 %CI 1.01-15.74).

    Conclusions: Long-term outcomes post-first IS vary among TOAST subtypes. Anticoagulant therapy offers long-term benefits among patients of the CE. However, prolonged administration of antiplatelet drugs among SAO patients may be limited in improving function recovery. Physicians should carefully consider treatment options for different IS subtypes to optimize patient outcomes and stroke care effectiveness.

    Keywords: Antiplatelet; Antithrombotic; Ischemic Stroke; Prognosis; TOAST subtypes.

    Keywords：ischemic stroke; long-term outcomes; toast subtypes

    关键词：缺血性卒中; 长期预后; Toast分型

    Copyright © Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 中文内容为AI机器翻译，仅供参考！

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    期刊名：Journal of stroke & cerebrovascular diseases

    缩写：J STROKE CEREBROVASC

    ISSN：1052-3057

    e-ISSN：1532-8511

    IF/分区：2.0/Q3

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    Long-term outcomes among ischemic stroke TOAST subtypes: A 12-year Cohort study in China