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Impact of white matter hyperintensity on the long-term outcome in stroke patients with large artery atherosclerosis
DC Field | Value | Language |
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dc.contributor.author | 백민렬 | - |
dc.date.accessioned | 2017-07-11T16:10:25Z | - |
dc.date.available | 2017-07-11T16:10:25Z | - |
dc.date.issued | 2016 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/149169 | - |
dc.description | Dept. of Medicine/석사 | - |
dc.description.abstract | Background: The presence of white matter hyperintensity (WMH) is related with poor long-term outcomes. Previous studies showed that the highest mortality rates were reported in patients with large atherosclerosis (LAA) or cardioembolism, and the lowest with lacunar strokes. However long-term outcome is unknown in patients with LAA and WMH. We investigated the impact of WMH on the long-term outcome in patients with LAA. Methods : From May 1999 to June 2007, consecutive patients with acute ischemic stroke were included. They were followed for a median of 7.7 years (interquartile range, 5.5–9.9). Long-term mortality and causes of death were identified using death certificates or telephone interviews. Degree of WMH was assessed by Fazekas grade on fluid-attenuated inversion recovery image. Severe WMH was defined as Fazekas grade ≥2. Results: Among 2913 patients, the stroke subtype was LAA in 753 patients (25.8%). After excluding patients with unavailable FLAIR images, data of 556 patients were analyzed. Mean age was 65.6 ± 10.3 years and 66.9% were men. Severe WMHs were found in 286 patients (51.4%). During follow-up, 208 patients (37.4%) died. The Kaplan-Meier survival analysis showed that old age, diabetes, initial national institutes of health stroke scale, and severe WMH were associated with long-term mortality. The Cox regression analysis showed that severe WMH was an independent predictor for long-term mortality. LAA patients with severe WMH showed 1.57-fold (95% CI, 1.17-2.11) higher mortality rate compared to those without. Conclusion: The degree of WMH might be one of surrogate markers for long-term outcome in patients with LAA. Atherosclerotic burdens in both small and large arteries might impact on long-term prognosis in ischemic stroke patients. | - |
dc.description.statementOfResponsibility | open | - |
dc.publisher | Graduate School, Yonsei University | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/2.0/kr/ | - |
dc.title | Impact of white matter hyperintensity on the long-term outcome in stroke patients with large artery atherosclerosis | - |
dc.title.alternative | 뇌백질 변화가 동맥경화성성 뇌경색 환자의 장기 예후에 미치는 영향 | - |
dc.type | Thesis | - |
dc.contributor.alternativeName | Baik, Minyoul | - |
dc.type.local | Thesis | - |
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