AimThe aim of this study was to investigate baseline characteristics and outcome of patients after endovascular therapy (EVT) for acute large vessel occlusion (LVO) in relation to their history of symptomatic vascular disease and sex.MethodsConsecutive EVT-eligible patients with LVO in the anterior circulation admitted to our stroke center between 04/2015 and 04/2020 were included in this observational cohort study. All patients were treated according to a standardized acute ischaemic stroke (AIS) protocol. Baseline characteristics and successful reperfusion, recurrent/progressive in-hospital ischaemic stroke, symptomatic in-hospital intracranial hemorrhage, death at discharge and at 3 months, and functional outcome at 3 months were analyzed according to previous symptomatic vascular disease and sex.Results995 patients with LVO in the anterior circulation (49.4% women, median age 76 years, median admission NIHSS score 14) were included. Patients with multiple vs. no previous vascular events showed higher mortality at discharge (20% vs. 9.3%, age/sex − adjustedOR = 1.43, p = 0.030) and less independency at 3 months (28.8% vs. 48.8%, age/sex − adjustedOR = 0.72, p = 0.020). All patients and men alone with one or multiple vs. patients and men with no previous vascular events showed more recurrent/progressive in-hospital ischaemic strokes (19.9% vs. 6.4% in all patients, age/sex − adjustedOR = 1.76, p = 0.028) (16.7% vs. 5.8% in men, age-adjustedOR = 2.20, p = 0.035). Men vs. women showed more in-hospital symptomatic intracranial hemorrhage among patients with one or multiple vs. no previous vascular events (23.7% vs. 6.6% in men and 15.4% vs. 5.5% in women, OR = 2.32, p = 0.035/age − adjustedOR = 2.36, p = 0.035).ConclusionsPrevious vascular events increased the risk of in-hospital complications and poorer outcome in the analyzed patients with EVT-eligible LVO-AIS. Our findings may support risk assessment in these stroke patients and could contribute to the design of future studies.

中文翻译：

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根据既往症状性血管疾病和性别，卒中患者血管内治疗后的基线特征和结果

目的本研究的目的是调查急性大血管闭塞 (LVO) 血管内治疗 (EVT) 后患者的基线特征和结果与其症状性血管疾病史和性别的关系。方法连续接受 EVT 的前壁 LVO 患者2015 年 4 月至 2020 年 4 月期间入住我们卒中中心的循环患者均纳入本观察性队列研究。所有患者均根据标准化急性缺血性中风（AIS）方案进行治疗。根据既往有症状的血管疾病和性别，分析基线特征和成功再灌注、复发/进行性院内缺血性卒中、有症状的院内颅内出血、出院时和 3 个月时的死亡以及 3 个月时的功能结果。前循环 LVO（49.4% 女性，中位年龄 76 岁，中位入院 NIHSS 评分 14）被纳入其中。与先前没有发生过多次血管事件的患者相比，出院时的死亡率更高（20% vs. 9.3%，年龄/性别 - 调整后或 = 1.43，p= 0.030），3 个月时独立性较低（28.8% 对比 48.8%，年龄/性别 - 调整后或 = 0.72，p= 0.020）。与既往没有血管事件的患者和男性相比，所有单独发生一种或多种的患者和男性表现出更多的院内缺血性卒中复发/进行性（所有患者中分别为 19.9% 和 6.4%，年龄/性别 - 调整后或 = 1.76，p= 0.028)（男性为 16.7% vs. 5.8%，年龄调整后 OR = 2.20，p= 0.035）。与既往无血管事件的患者相比，男性在发生过一次或多次血管事件的院内症状性颅内出血的比例更高（男性为 23.7%，女性为 6.6%，女性为 15.4%，女性为 5.5%，OR = 2.32，p= 0.035/年龄 - 调整后或 = 2.36，p= 0.035)。 结论 在分析的符合 EVT 资格的 LVO-AIS 患者中，既往血管事件增加了院内并发症的风险，且预后较差。我们的研究结果可能支持这些中风患者的风险评估，并有助于未来研究的设计。