Scholarlink

Purpose <p>To assess the proportion of early neurological deterioration (END) in patients with minor stroke, its impact on 3-month clinical outcomes, and the influence of large vessel occlusion (LVO) location on END development.</p> Methods <p>We analyzed patients from the CICAT Code Stroke Registry in Catalonia, Spain, between January 1, 2016, and December 31, 2021. Inclusion criteria were baseline NIHSS ≤ 5, treatment with intravenous thrombolysis (IVT) with or without endovascular treatment (EVT), and available acute vascular imaging. END was defined as an NIHSS increase of ≥ 4 points at 24–36&#xa0;h post-treatment. Poor clinical outcome was defined as modified Rankin Scale (mRS) 3–6 at 3 months.</p> Findings <p>A total of 1,380 patients were included (median age 71 [IQR 59–79] years; 59% male; median NIHSS 4 [IQR 3–5]). LVO was present in 282 patients (20.4%). END occurred in 73 patients (5.3%): 12.1% with LVO vs. 3.6% without LVO (<i>p</i> &lt; 0.001). LVO was the strongest predictor of END (OR 3.73; 95% CI 2.30–6.06; <i>p</i> &lt; 0.001), regardless of occlusion level. Poor 3-month outcome was observed in 74% of patients with END, compared to 26.8% without END (<i>p</i> &lt; 0.001). END independently predicted poor outcome (OR 6.79; 95% CI 3.23–14.31).</p> Conclusions <p>In minor stroke patients treated with IVT or IVT + EVT, LVO was the primary driver of END even for mediun-sized arteries. END emerged as the strongest predictor of poor 3-month functional outcome.</p> Graphical Abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Impact of arterial occlusion location on early neurological deterioration in patients with minor stroke treated with intravenous thrombolysis. The MINORCAT-END study

  • 期刊论文

  • 发表日期：

    2025年12月17日

查看全文
  • Maria Àngels Font,
  • Sonia María García-Sánchez,
  • Juan José Mengual,
  • Carla Avellaneda-Gómez,
  • Sandra Boned,
  • Josep Maria Aragonès,
  • Yolanda Silva,
  • Marina Martínez,
  • Antonio Doncel-Moriano,
  • Xavier Ustrell,
  • Pol Camps-Renom,
  • Gerard Mauri-Capdevila,
  • Francisco Purroy,
  • Ana Rodríguez-Campello,
  • Ernest Palomeras,
  • Jerzy Krupinski,
  • Georgina Figueras-Aguirre,
  • Ester Catena,
  • Jessica García-Alhama,
  • Patricia Esteve-Belloch,
  • Nuria Matos,
  • Carla Colom,
  • Oriol Aguiló,
  • Anna Coll,
  • Glòria Díaz,
  • Ester Tió,
  • Orlando Ortega,
  • Sebastià Alfonso,
  • Xavier Jiménez-Fàbrega,
  • Mercè Salvat-Plana,
  • Roberto Elosua,
  • Natalia Pérez de la Ossa,
  • Sonia Abilleira,
  • Manuel Gómez-Choco

摘要

Purpose

To assess the proportion of early neurological deterioration (END) in patients with minor stroke, its impact on 3-month clinical outcomes, and the influence of large vessel occlusion (LVO) location on END development.

Methods

We analyzed patients from the CICAT Code Stroke Registry in Catalonia, Spain, between January 1, 2016, and December 31, 2021. Inclusion criteria were baseline NIHSS ≤ 5, treatment with intravenous thrombolysis (IVT) with or without endovascular treatment (EVT), and available acute vascular imaging. END was defined as an NIHSS increase of ≥ 4 points at 24–36 h post-treatment. Poor clinical outcome was defined as modified Rankin Scale (mRS) 3–6 at 3 months.

Findings

A total of 1,380 patients were included (median age 71 [IQR 59–79] years; 59% male; median NIHSS 4 [IQR 3–5]). LVO was present in 282 patients (20.4%). END occurred in 73 patients (5.3%): 12.1% with LVO vs. 3.6% without LVO (p < 0.001). LVO was the strongest predictor of END (OR 3.73; 95% CI 2.30–6.06; p < 0.001), regardless of occlusion level. Poor 3-month outcome was observed in 74% of patients with END, compared to 26.8% without END (p < 0.001). END independently predicted poor outcome (OR 6.79; 95% CI 3.23–14.31).

Conclusions

In minor stroke patients treated with IVT or IVT + EVT, LVO was the primary driver of END even for mediun-sized arteries. END emerged as the strongest predictor of poor 3-month functional outcome.

Graphical Abstract