Pretreatment factors associated with symptomatic stroke in Moyamoya disease patients: A multicenter study.
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Musmar Basel, Roy Joanna M, Salim Hamza Adel, Kaul Anand, Atallah Elias, Naamani Kareem El, Chen Ching-Jen, Jabre Roland, Saad Hassan, Grossberg Jonathan A, Dmytriw Adam A, Patel Aman B, Khorasanizadeh Mirhojjat, Ogilvy Christopher S, Thomas Ajith J, Monteiro Andre, Siddiqui Adnan, Cortez Gustavo M, Hanel Ricardo A, Porto Guilherme, Spiotta Alejandro M, Piscopo Anthony J, Hasan David M, Ghorbani Mohammad, Weinberg Joshua, Nimjee Shahid M, Bekelis Kimon, Salem Mohamed M, Burkhardt Jan-Karl, Zetchi Akli, Matouk Charles, Howard Brian M, Lai Rosalind, Du Rose, Abbas Rawad, Sioutas Georgios S, Amllay Abdelaziz, Munoz Alfredo, Herial Nabeel A, Tjoumakaris Stavropoula I, Gooch Michael Reid, Rosenwasser Robert H, Jabbour Pascal
Аннотация
METHODS: This study is a multicenter retrospective analysis conducted across 13 academic institutions in North America. A total of 518 patients with MMD were included. Data collected included patient demographics, disease characteristics, and follow-up duration. Stroke-free survival was analyzed using Kaplan-Meier curves. Univariate and multivariable Cox regression analyses were used to identify risk factors for symptomatic stroke.
RESULTS: The median age of the patients was 43 years (IQR, 34-52 years), and 370 (71 %) were females. Multivariable Cox regression identified advanced age (HR 1.03, 95 % CI 1.01-1.05, p = 0.011), female sex (HR 2.03, 95 % CI 1.00-4.11, p = 0.049), diabetes mellitus (HR 2.03, 95 % CI 1.14-3.63, p = 0.016), smoking status (HR 2.27, 95 % CI 1.27-4.05, p = 0.006), and asymptomatic disease (HR 0.37, 95 % CI 0.15-0.93, p = 0.034) as significant factors associated with symptomatic stroke.
CONCLUSION: Advanced age, female sex, diabetes mellitus, and smoking status were significant predictors of symptomatic stroke in MMD patients after bypass surgery. Asymptomatic patients had a reduced risk of stroke. These findings emphasize the importance of managing modifiable risk factors and the potential benefits of early detection in improving clinical outcomes for MMD patients. Further prospective studies are needed to validate these findings.