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Post-stroke cognitive impairment as an independent predictor of ischemic stroke recurrence: PICASSO sub-study

Post-stroke cognitive impairment as an independent predictor of ischemic stroke recurrence:... IntroductionTo devise appropriate preventive strategies after stroke, knowledge of the association between post-stroke cognitive impairment (PSCI) and prognosis of stroke patients is important. We investigated the association between PSCI and the vascular outcomes in patients with ischemic stroke with best medical care considering their risk factors and adherence to medications.MethodsOf the 1534 ischemic stroke patients who randomly assigned to aspirin or cilostazol treatment with best medical therapy by the PICASSO (PreventIon of CArdiovascular events in iSchemic Stroke patients with high risk of cerebral hemOrrhage) trial, 1240 with baseline mini-mental state examination (MMSE) scores were analysed retrospectively. The patients were classified into three groups based on MMSE scores. Recurrence of ischemic stroke, stroke of any type and composite of major vascular events were compared among them.ResultsOf the 1240 patients, 376 had MMSE scores of 28–30 (highest tertile), 419 had scores of 24–27 (middle tertile) and 445 had scores of 0–23 (lowest tertile). The average time from stroke onset to MMSE examination was 31.8 days. By trend analysis, lower tertile of MMSE score was significantly associated with recurrent ischemic stroke (p = 0.0017), stroke of any type (p = 0.0053) and composite vascular outcome (p = 0.0122). After adjustment for covariates, PSCI was independently associated with risk of recurrent ischemic stroke (HR 2.40, 95% confidence interval 1.12–5.14).ConclusionsCognitive impairment was associated with recurrence of ischemic stroke in high risk patients during adequate medical therapy including antiplatelet therapy. However, the other vascular events were not. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Neurology Springer Journals

Post-stroke cognitive impairment as an independent predictor of ischemic stroke recurrence: PICASSO sub-study

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References (19)

Publisher
Springer Journals
Copyright
Copyright © Springer-Verlag GmbH Germany, part of Springer Nature 2019
Subject
Medicine & Public Health; Neurology; Neurosciences; Neuroradiology
ISSN
0340-5354
eISSN
1432-1459
DOI
10.1007/s00415-019-09630-4
Publisher site
See Article on Publisher Site

Abstract

IntroductionTo devise appropriate preventive strategies after stroke, knowledge of the association between post-stroke cognitive impairment (PSCI) and prognosis of stroke patients is important. We investigated the association between PSCI and the vascular outcomes in patients with ischemic stroke with best medical care considering their risk factors and adherence to medications.MethodsOf the 1534 ischemic stroke patients who randomly assigned to aspirin or cilostazol treatment with best medical therapy by the PICASSO (PreventIon of CArdiovascular events in iSchemic Stroke patients with high risk of cerebral hemOrrhage) trial, 1240 with baseline mini-mental state examination (MMSE) scores were analysed retrospectively. The patients were classified into three groups based on MMSE scores. Recurrence of ischemic stroke, stroke of any type and composite of major vascular events were compared among them.ResultsOf the 1240 patients, 376 had MMSE scores of 28–30 (highest tertile), 419 had scores of 24–27 (middle tertile) and 445 had scores of 0–23 (lowest tertile). The average time from stroke onset to MMSE examination was 31.8 days. By trend analysis, lower tertile of MMSE score was significantly associated with recurrent ischemic stroke (p = 0.0017), stroke of any type (p = 0.0053) and composite vascular outcome (p = 0.0122). After adjustment for covariates, PSCI was independently associated with risk of recurrent ischemic stroke (HR 2.40, 95% confidence interval 1.12–5.14).ConclusionsCognitive impairment was associated with recurrence of ischemic stroke in high risk patients during adequate medical therapy including antiplatelet therapy. However, the other vascular events were not.

Journal

Journal of Neurology – Springer Journals

Published: Mar 12, 2020

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