One-Year Risk of Recurrent Stroke and Death Associated with Vertebrobasilar Artery Stenosis and Occlusion in a Cohort of 10,515 Patients

Adnan I. Qureshi, Mushtaq H. Qureshi, Li Ming Lien, Jiunn Tay Lee, Jiann Shing Jeng, Chaur Jong Hu, Ta Chang Lai, Chung Hsiang Liu, Chih Hung Chen, Po Lin Chen, Tsang Shan Chen, Jie Yuan Li, Cheng Li Lin, Chung Y. Hsu

Research output: Contribution to journalArticle

Abstract

The natural history of vertebrobasilar artery (VBA) stenosis or occlusion remains understudied. >bold<>italic<Methods:>/italic<>/bold< Patients with diagnosis of ischemic stroke or transient ischemic attack (TIA) who were noted to have VBA stenosis based on computed tomography or magnetic resonance imaging or catheter-based angiogram were selected from Taiwan Stroke Registry. Cox proportional hazards model was used to determine the hazards ratio (HR) of recurrent stroke and death within 1 year of index event in various groups based on severity of VBA stenosis (none to mild: 0-49%; moderate to severe: 50-99%: occlusion: 100%) after adjusting for differences in demographic and clinical characteristics between groups at baseline evaluation. >bold<>italic<Results:>/italic<>/bold< None to mild or moderate to severe VBA stenosis was diagnosed in 6972 (66%) and 3,137 (29.8%) among 10,515 patients, respectively, and occlusion was identified in 406 (3.8%) patients. Comparing with patients who showed none to mild stenosis of VBA, there was a significantly higher risk of recurrent stroke (HR 1.21, 95% CI 1.01-1.45) among patients with moderate to severe VBA stenosis. There was a nonsignificantly higher risk of recurrent stroke (HR 1.49, 95% CI 0.99-2.22) and significantly higher risk of death (HR 2.21, 95% CI 1.72-2.83), among patients with VBA occlusion after adjustment of potential confounders. >bold<>italic<Conclusions:>/italic<>/bold< VBA stenosis or occlusion was relatively prevalent among patients with TIA or ischemic stroke and associated with higher risk of recurrent stroke and death in patients with ischemic stroke or TIA who had large artery atherosclerosis>bold<>italic<.>/italic<>/bold<.

Original languageEnglish
Pages (from-to)40-47
Number of pages8
JournalCerebrovascular Diseases
Volume47
Issue number1-2
DOIs
Publication statusPublished - 2019 Apr 1

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Natural History
Pathologic Constriction
Arteries
Stroke

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Qureshi, Adnan I. ; Qureshi, Mushtaq H. ; Lien, Li Ming ; Lee, Jiunn Tay ; Jeng, Jiann Shing ; Hu, Chaur Jong ; Lai, Ta Chang ; Liu, Chung Hsiang ; Chen, Chih Hung ; Chen, Po Lin ; Chen, Tsang Shan ; Li, Jie Yuan ; Lin, Cheng Li ; Hsu, Chung Y. / One-Year Risk of Recurrent Stroke and Death Associated with Vertebrobasilar Artery Stenosis and Occlusion in a Cohort of 10,515 Patients. In: Cerebrovascular Diseases. 2019 ; Vol. 47, No. 1-2. pp. 40-47.
@article{3a732c6eb1e44c52b13e6c88c2853c0a,
title = "One-Year Risk of Recurrent Stroke and Death Associated with Vertebrobasilar Artery Stenosis and Occlusion in a Cohort of 10,515 Patients",
abstract = "The natural history of vertebrobasilar artery (VBA) stenosis or occlusion remains understudied. >bold<>italic<Methods:>/italic<>/bold< Patients with diagnosis of ischemic stroke or transient ischemic attack (TIA) who were noted to have VBA stenosis based on computed tomography or magnetic resonance imaging or catheter-based angiogram were selected from Taiwan Stroke Registry. Cox proportional hazards model was used to determine the hazards ratio (HR) of recurrent stroke and death within 1 year of index event in various groups based on severity of VBA stenosis (none to mild: 0-49{\%}; moderate to severe: 50-99{\%}: occlusion: 100{\%}) after adjusting for differences in demographic and clinical characteristics between groups at baseline evaluation. >bold<>italic<Results:>/italic<>/bold< None to mild or moderate to severe VBA stenosis was diagnosed in 6972 (66{\%}) and 3,137 (29.8{\%}) among 10,515 patients, respectively, and occlusion was identified in 406 (3.8{\%}) patients. Comparing with patients who showed none to mild stenosis of VBA, there was a significantly higher risk of recurrent stroke (HR 1.21, 95{\%} CI 1.01-1.45) among patients with moderate to severe VBA stenosis. There was a nonsignificantly higher risk of recurrent stroke (HR 1.49, 95{\%} CI 0.99-2.22) and significantly higher risk of death (HR 2.21, 95{\%} CI 1.72-2.83), among patients with VBA occlusion after adjustment of potential confounders. >bold<>italic<Conclusions:>/italic<>/bold< VBA stenosis or occlusion was relatively prevalent among patients with TIA or ischemic stroke and associated with higher risk of recurrent stroke and death in patients with ischemic stroke or TIA who had large artery atherosclerosis>bold<>italic<.>/italic<>/bold<.",
author = "Qureshi, {Adnan I.} and Qureshi, {Mushtaq H.} and Lien, {Li Ming} and Lee, {Jiunn Tay} and Jeng, {Jiann Shing} and Hu, {Chaur Jong} and Lai, {Ta Chang} and Liu, {Chung Hsiang} and Chen, {Chih Hung} and Chen, {Po Lin} and Chen, {Tsang Shan} and Li, {Jie Yuan} and Lin, {Cheng Li} and Hsu, {Chung Y.}",
year = "2019",
month = "4",
day = "1",
doi = "10.1159/000495418",
language = "English",
volume = "47",
pages = "40--47",
journal = "Cerebrovascular Diseases",
issn = "1015-9770",
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}

Qureshi, AI, Qureshi, MH, Lien, LM, Lee, JT, Jeng, JS, Hu, CJ, Lai, TC, Liu, CH, Chen, CH, Chen, PL, Chen, TS, Li, JY, Lin, CL & Hsu, CY 2019, 'One-Year Risk of Recurrent Stroke and Death Associated with Vertebrobasilar Artery Stenosis and Occlusion in a Cohort of 10,515 Patients', Cerebrovascular Diseases, vol. 47, no. 1-2, pp. 40-47. https://doi.org/10.1159/000495418

One-Year Risk of Recurrent Stroke and Death Associated with Vertebrobasilar Artery Stenosis and Occlusion in a Cohort of 10,515 Patients. / Qureshi, Adnan I.; Qureshi, Mushtaq H.; Lien, Li Ming; Lee, Jiunn Tay; Jeng, Jiann Shing; Hu, Chaur Jong; Lai, Ta Chang; Liu, Chung Hsiang; Chen, Chih Hung; Chen, Po Lin; Chen, Tsang Shan; Li, Jie Yuan; Lin, Cheng Li; Hsu, Chung Y.

In: Cerebrovascular Diseases, Vol. 47, No. 1-2, 01.04.2019, p. 40-47.

Research output: Contribution to journalArticle

TY - JOUR

T1 - One-Year Risk of Recurrent Stroke and Death Associated with Vertebrobasilar Artery Stenosis and Occlusion in a Cohort of 10,515 Patients

AU - Qureshi, Adnan I.

AU - Qureshi, Mushtaq H.

AU - Lien, Li Ming

AU - Lee, Jiunn Tay

AU - Jeng, Jiann Shing

AU - Hu, Chaur Jong

AU - Lai, Ta Chang

AU - Liu, Chung Hsiang

AU - Chen, Chih Hung

AU - Chen, Po Lin

AU - Chen, Tsang Shan

AU - Li, Jie Yuan

AU - Lin, Cheng Li

AU - Hsu, Chung Y.

PY - 2019/4/1

Y1 - 2019/4/1

N2 - The natural history of vertebrobasilar artery (VBA) stenosis or occlusion remains understudied. >bold<>italic<Methods:>/italic<>/bold< Patients with diagnosis of ischemic stroke or transient ischemic attack (TIA) who were noted to have VBA stenosis based on computed tomography or magnetic resonance imaging or catheter-based angiogram were selected from Taiwan Stroke Registry. Cox proportional hazards model was used to determine the hazards ratio (HR) of recurrent stroke and death within 1 year of index event in various groups based on severity of VBA stenosis (none to mild: 0-49%; moderate to severe: 50-99%: occlusion: 100%) after adjusting for differences in demographic and clinical characteristics between groups at baseline evaluation. >bold<>italic<Results:>/italic<>/bold< None to mild or moderate to severe VBA stenosis was diagnosed in 6972 (66%) and 3,137 (29.8%) among 10,515 patients, respectively, and occlusion was identified in 406 (3.8%) patients. Comparing with patients who showed none to mild stenosis of VBA, there was a significantly higher risk of recurrent stroke (HR 1.21, 95% CI 1.01-1.45) among patients with moderate to severe VBA stenosis. There was a nonsignificantly higher risk of recurrent stroke (HR 1.49, 95% CI 0.99-2.22) and significantly higher risk of death (HR 2.21, 95% CI 1.72-2.83), among patients with VBA occlusion after adjustment of potential confounders. >bold<>italic<Conclusions:>/italic<>/bold< VBA stenosis or occlusion was relatively prevalent among patients with TIA or ischemic stroke and associated with higher risk of recurrent stroke and death in patients with ischemic stroke or TIA who had large artery atherosclerosis>bold<>italic<.>/italic<>/bold<.

AB - The natural history of vertebrobasilar artery (VBA) stenosis or occlusion remains understudied. >bold<>italic<Methods:>/italic<>/bold< Patients with diagnosis of ischemic stroke or transient ischemic attack (TIA) who were noted to have VBA stenosis based on computed tomography or magnetic resonance imaging or catheter-based angiogram were selected from Taiwan Stroke Registry. Cox proportional hazards model was used to determine the hazards ratio (HR) of recurrent stroke and death within 1 year of index event in various groups based on severity of VBA stenosis (none to mild: 0-49%; moderate to severe: 50-99%: occlusion: 100%) after adjusting for differences in demographic and clinical characteristics between groups at baseline evaluation. >bold<>italic<Results:>/italic<>/bold< None to mild or moderate to severe VBA stenosis was diagnosed in 6972 (66%) and 3,137 (29.8%) among 10,515 patients, respectively, and occlusion was identified in 406 (3.8%) patients. Comparing with patients who showed none to mild stenosis of VBA, there was a significantly higher risk of recurrent stroke (HR 1.21, 95% CI 1.01-1.45) among patients with moderate to severe VBA stenosis. There was a nonsignificantly higher risk of recurrent stroke (HR 1.49, 95% CI 0.99-2.22) and significantly higher risk of death (HR 2.21, 95% CI 1.72-2.83), among patients with VBA occlusion after adjustment of potential confounders. >bold<>italic<Conclusions:>/italic<>/bold< VBA stenosis or occlusion was relatively prevalent among patients with TIA or ischemic stroke and associated with higher risk of recurrent stroke and death in patients with ischemic stroke or TIA who had large artery atherosclerosis>bold<>italic<.>/italic<>/bold<.

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