BMJ Neurology Open (Apr 2022)
Prognosis and antiplatelet therapy of small single subcortical infarcts in penetrating artery territory: a post hoc analysis of the Third China National Stroke Registry
- ,
- Xu Zhang,
- Yongjun Wang,
- Kangning Chen,
- Lianbo Gao,
- Ye Tian,
- Xu Chen,
- Yi Guo,
- Benyan Luo,
- Yan Wang,
- Jian Wu,
- Xiaohong Li,
- An-Xin Wang,
- Yong-Jun Wang,
- Qiang Dong,
- Huisheng Chen,
- Wei Wang,
- Zhengqi Lu,
- Jing Jing,
- Lijie Ren,
- Runqing Wang,
- Juan Feng,
- Zhangyong Xia,
- Hao Li,
- Lihua Wang,
- Qingwei Zhao,
- Hong Wang,
- Ting Wang,
- Jin Zhou,
- Xia Meng,
- Jun Wu,
- Qing Li,
- Shizheng Wu,
- Ping Zhang,
- Li-Ping Liu,
- Yi-long Wang,
- Ming Yu,
- Guohua Chen,
- Zhimin Wang,
- Jianhua Li,
- Yi Wang,
- Yi Yang,
- Xinsheng Han,
- Songdi Wu,
- Yongming Chen,
- Liang Zhao,
- Qiang Ma,
- Xiaoying Zhang,
- Mei Zhang,
- Limin Wang,
- Hui Liang,
- Liping Wang,
- Jun Zhou,
- Jie Lin,
- Yu Geng,
- Ning Wang,
- Yun Xu,
- Jinsheng Zeng,
- Huijuan Wang,
- Xueli Cai,
- Jia Yin,
- Jun Xu,
- Feng Qiu,
- Jun Zhao,
- Baojun Wang,
- Hainan Zhang,
- Zi-Xiao Li,
- Xing-Quan Zhao,
- Mingzhi Zhao,
- Yingchun Wu,
- Junling Zhang,
- Xuerong Qiu,
- Zhongping An,
- Wenjun Xue,
- Lili Zhao,
- Hongyan Li,
- Junfeng Shi,
- Mingzhen Li,
- Tao Gong,
- Qi Fang,
- Liyan Liu,
- Jianfeng Wang,
- Guang Huang,
- Chun Wang,
- Yuwu Zhao,
- Lei Sheng,
- Lei Xia,
- Yan Fang,
- Xiaoxiang Peng,
- Yanling Wang,
- Yangmei Chen,
- Deqin Geng,
- Jinfeng Liu,
- Weirong Li,
- Yuqing Wei,
- Yu-Yuan Xu,
- Yi-Jun Zhang,
- Jilai Li,
- Maolin He,
- Quping Ouyang,
- Fengchun Yu,
- Chenlong Wang,
- Jinli Zhang,
- Wenqing Wu,
- Yaoyu Yu,
- Meiyun Zhang,
- Junyan Liu,
- Wanying Shi,
- Baoquan Lu,
- Lijun Geng,
- Shujuan Wang,
- Ruifang Liu,
- Fengli Zhao,
- Xinping Liu,
- Xuebing Sun,
- Tianyuan Li,
- Youming Wang,
- Xinxia He,
- Weiqiang Yuan,
- Ronghua Dou,
- Lihai Liu,
- Haisong Du,
- Cunrui Wang,
- Yu'an Zou,
- Xiaofei Chen,
- Fengyun Hu,
- Fanping He,
- Xingchen Wang,
- Hongjin Li,
- Mingzong Yan,
- Guiru Zhang,
- Yunlin Liu,
- Yuhui Han,
- Xianghong Meng,
- Hongtian Zhang,
- Congmin Ma,
- Gexia Liu,
- Wenxu Zheng,
- Haitao Chi,
- Hongbo Xiao,
- Lijun Xiao,
- Guozhong Li,
- Yulan Zhu,
- Yindong Yang,
- Xuhai Gong,
- Qunhui Liu,
- Shiping Gong,
- Hongbin Zhou,
- Haipeng Li,
- Yong You,
- Jinsheng Lin,
- Heqing Zhao,
- Aixia Zhuang,
- Kaifu Ke,
- Zhengxie Dong,
- Guiyun Cui,
- Liangqun Rong,
- Yi Wu,
- Weiguo Tang,
- Yanjiang Wang,
- Wenguang Bu,
- Xiaohua Cheng,
- An'ding Xu,
- Jifu Cai,
- Lvli Li,
- Li Pan; Yinzhou Wang,
- Jianping Niu,
- Liping Zhan,
- Li'e Wu,
- Li Liu; Yanru Zhao,
- Runxiu Zhu,
- Yanhui Du,
- Yongxia Wen,
- Yongcai Qu,
- Yuncheng Wu,
- Jianren Liu,
- Qingke Bai,
- Chaoming He,
- Weiwen Qiu,
- Shufang Yao,
- Xuwen Sun,
- Ligong Gao,
- Xianglin Chen,
- Qiuyan Shi,
- Zhaochen Li,
- Tianbao Chen,
- SuYun Yang,
- Yazhou Han,
- Xinxiao Wu,
- Beihai Jiang,
- Lizhong Li,
- Weidong Lou,
- Weiming Lan,
- Aihu Zheng,
- Qifu Bai,
- Lifang Luan,
- Liqing Yan,
- Yanxia Wang,
- Xuerong Huang,
- Xiangting Chai,
- Yanshu Liu,
- Liangjun You,
- Hongqin Yang,
- Dongfang Li,
- Linying Gui,
- Aisheng Wu,
- Jianling Zhang,
- Dengling Wang,
- Qinghua Zhang,
- Yunhong He,
- Ruiyou Guo,
- Jijun Teng,
- Ping Lou
Affiliations
- Xu Zhang
- 1 Chinese Academy of Medical Sciences Institute of Dermatology, Nanjing, Jiangsu, China
- Yongjun Wang
- Neurology, Beijing Tiantan Hospital, Beijing, China
- Kangning Chen
- Lianbo Gao
- Ye Tian
- 1 Department of Anesthesiology and Intensive Care, The Second Hospital of Hebei Medical University, Shijiazhuang, China
- Xu Chen
- 1 Department of Pathology, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China
- Yi Guo
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA
- Benyan Luo
- Yan Wang
- 3 Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
- Jian Wu
- 5the First Affiliated Hospital of SOOCHOW University, Suzhou, China
- Xiaohong Li
- Department of Nephrology (Key Laboratory of Kidney Disease Prevention and Control Technology), Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- An-Xin Wang
- China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Yong-Jun Wang
- 2 China National Clinical Research centre for Neurological Diseases, Beijing, China
- Qiang Dong
- Department of Neurology, National Center for Neurological Disorders, National Clinical Research Centre for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Huisheng Chen
- Wei Wang
- 1 Department of Orthopaedics, Qilu Hospital of Shandong University, Shandong University Centre for Orthopaedics, Advanced Medical Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Zhengqi Lu
- Jing Jing
- professor
- Lijie Ren
- Runqing Wang
- Juan Feng
- Zhangyong Xia
- Department of Neurology, Liaocheng People’s Hospital, Shandong University, Liaocheng, Shandong, P.R. China
- Hao Li
- professor
- Lihua Wang
- 2 Department of Nursing, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
- Qingwei Zhao
- 2 Department of Clinical Pharmacy, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, China
- Hong Wang
- Ting Wang
- Department of Nursing, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Jin Zhou
- 3Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Department of Pain Management, Shanghai, China
- Xia Meng
- professor
- Jun Wu
- Department of Neurosurgery and China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China
- Qing Li
- Shanghai Key Laboratory of Medical Epigenetics, International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- Shizheng Wu
- Ping Zhang
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China
- Li-Ping Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, Beijing, China
- Yi-long Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, Beijing, China
- Ming Yu
- Guohua Chen
- Zhimin Wang
- Jianhua Li
- The First Hospital of Fangshan District, Beijing, China
- Yi Wang
- Department of Nephrology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Yi Yang
- School of Management, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- Xinsheng Han
- Kaifeng Central Hospital, Henan, China
- Songdi Wu
- Department of Neurology, Xi’an No.1 Hospital, The First Affiliated Hospital of Northwest University, Xi`an, Shaanxi, China
- Yongming Chen
- Liang Zhao
- 2 Shandong University, Jinan, Shandong, China
- Qiang Ma
- Xiaoying Zhang
- Mei Zhang
- Department of Rehabilitation, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Limin Wang
- professor in epidemiology
- Hui Liang
- Liping Wang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Jun Zhou
- 1 Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
- Jie Lin
- Department of Pathology, The Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Baise, Guangxi, China
- Yu Geng
- Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, China
- Ning Wang
- Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China
- Yun Xu
- Department of Health Care, China Academy of Chinese Medical Sciences Guang`anmen Hospital, Beijing, China
- Jinsheng Zeng
- Neurology, Sun Yat-sen University First Affiliated Hospital, Guangzhou, Guangdong, China
- Huijuan Wang
- Beijing Chao-Yang Hospital Capital Medical University, Beijing, China
- Xueli Cai
- Department of Neurology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, China
- Jia Yin
- Jun Xu
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- Feng Qiu
- Jun Zhao
- Department of Thoracic Medical Oncology, Beijing Cancer Hospital, Beijing, China
- Baojun Wang
- Hainan Zhang
- 12 Department of Neurology, The Second Xiangya Hospital, Central South University, Hunan, China
- Zi-Xiao Li
- 2 China National Clinical Research centre for Neurological Diseases, Beijing, China
- Xing-Quan Zhao
- 2 China National Clinical Research centre for Neurological Diseases, Beijing, China
- Mingzhi Zhao
- Yingchun Wu
- Junling Zhang
- Xuerong Qiu
- Zhongping An
- Wenjun Xue
- Lili Zhao
- 1 Department of Neurology, The Second Affiliated Hospital of Xi`an Jiaotong University, Xi`an, Shaanxi, China
- Hongyan Li
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou, Guangdong, China
- Junfeng Shi
- Mingzhen Li
- Tao Gong
- Qi Fang
- 1 Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Liyan Liu
- Jianfeng Wang
- Guang Huang
- Center for Global Health, Key Lab of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu Province, People`s Republic of China
- Chun Wang
- 3 Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China
- Yuwu Zhao
- Department of Neurology, Shanghai Sixth People`s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Lei Sheng
- Lei Xia
- Yan Fang
- Xiaoxiang Peng
- Department of Neurology, The Third People`s Hospital of Hubei Province, Wuhan, China
- Yanling Wang
- Yangmei Chen
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Deqin Geng
- Jinfeng Liu
- 2Gilead Sciences, Inc., Foster City, United States of America
- Weirong Li
- Yuqing Wei
- Yu-Yuan Xu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, Beijing, China
- Yi-Jun Zhang
- China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Jilai Li
- Maolin He
- Quping Ouyang
- Fengchun Yu
- Chenlong Wang
- Jinli Zhang
- Wenqing Wu
- Yaoyu Yu
- Meiyun Zhang
- Junyan Liu
- Wanying Shi
- Baoquan Lu
- Lijun Geng
- Shujuan Wang
- Ruifang Liu
- Fengli Zhao
- Xinping Liu
- Xuebing Sun
- Tianyuan Li
- Youming Wang
- Xinxia He
- Weiqiang Yuan
- Ronghua Dou
- Lihai Liu
- Haisong Du
- Cunrui Wang
- Yu'an Zou
- Xiaofei Chen
- Oncology Biometrics, AstraZeneca, Gaithersburg, Maryland, USA
- Fengyun Hu
- Fanping He
- Xingchen Wang
- Hongjin Li
- Mingzong Yan
- Guiru Zhang
- Yunlin Liu
- Yuhui Han
- Xianghong Meng
- Hongtian Zhang
- Congmin Ma
- Gexia Liu
- Wenxu Zheng
- Haitao Chi
- Hongbo Xiao
- Lijun Xiao
- Guozhong Li
- Yulan Zhu
- Yindong Yang
- Xuhai Gong
- Daqing Oilfield General Hospital, Daqing, Heilongjiang, China
- Qunhui Liu
- Shiping Gong
- Hongbin Zhou
- Haipeng Li
- Yong You
- Jinsheng Lin
- Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Heqing Zhao
- Aixia Zhuang
- Kaifu Ke
- Zhengxie Dong
- Guiyun Cui
- Liangqun Rong
- Yi Wu
- Department of Ophthalmology, China Medical University Second Hospital, Shenyang, China
- Weiguo Tang
- Yanjiang Wang
- Department of Neurology, Army Medical Center of PLA, Army Medical University, Chongqing, China
- Wenguang Bu
- Xiaohua Cheng
- An'ding Xu
- Jifu Cai
- Lvli Li
- Li Pan; Yinzhou Wang
- Jianping Niu
- Liping Zhan
- Li'e Wu
- Li Liu; Yanru Zhao
- Runxiu Zhu
- Yanhui Du
- Yongxia Wen
- Yongcai Qu
- Yuncheng Wu
- Jianren Liu
- Qingke Bai
- Chaoming He
- Weiwen Qiu
- Shufang Yao
- Xuwen Sun
- Ligong Gao
- Xianglin Chen
- Qiuyan Shi
- Zhaochen Li
- Tianbao Chen
- SuYun Yang
- Yazhou Han
- Xinxiao Wu
- Beihai Jiang
- Lizhong Li
- Weidong Lou
- Weiming Lan
- Aihu Zheng
- Qifu Bai
- Lifang Luan
- Liqing Yan
- Yanxia Wang
- Xuerong Huang
- Xiangting Chai
- Yanshu Liu
- Liangjun You
- Hongqin Yang
- professor
- Dongfang Li
- Linying Gui
- Aisheng Wu
- Jianling Zhang
- professor
- Dengling Wang
- Qinghua Zhang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Yunhong He
- Ruiyou Guo
- Jijun Teng
- Ping Lou
- DOI
- https://doi.org/10.1136/bmjno-2022-000267
- Journal volume & issue
-
Vol. 4,
no. 1
Abstract
Background Small single subcortical infarction (SSSI) may be classified as parent artery disease-related or only branch involved according to the stenosis of parent artery. The study aimed to evaluate short-term and long-term prognoses and the effectiveness of antiplatelet therapy in SSSI.Methods We prospectively enrolled 2890 patients with SSSI from the Third China National Stroke Registry (CNSR-III) database from August 2015 to March 2018. We assessed clinical outcomes and antiplatelet treatment effects in patients with SSSI with and without parent artery stenosis (PAS) identified by magnetic resonance angiography.Results Among 2890 patients with SSSI in the perforator territory of the middle cerebral artery and the basilar artery, there were 680 (23.53%) patients with PAS and 2210 (76.47%) patients without PAS, respectively. After adjusting for potential confounders, the PAS group had a greater initial stroke severity (OR 1.262, 95% CI 1.058 to 1.505; p=0.0097) and a higher risk of ischaemic stroke recurrence at 3 months (OR 2.266, 95% CI 1.631 to 3.149; p<0.0001) and 1 year (OR 2.054, 95% CI 1.561 to 2.702; p<0.0001), as well as composite vascular events at 3 months (OR 2.306, 95% CI 1.674 to 3.178; p<0.0001) and 1 year (OR 1.983, 95% CI 1.530 to 2.570; p<0.0001), compared with the non-PAS group. In both groups, dual antiplatelet therapy was not superior to single antiplatelet therapy in preventing stroke recurrence, composite vascular events and disability.Conclusion PAS related to significantly higher rates of short-term and long-term stroke recurrence and composite vascular events, suggesting heterogeneous mechanisms in SSSI subgroups. The effectiveness of antiplatelet therapy for SSSI needs further investigation.
