Insular involvement after cerebral infarction predicts the risk of cardioembolic stroke
Journal Title: Chinese Journal of Nervous and Mental Diseases - Year 2024, Vol 50, Issue 2
Abstract
[Objective] To determine whether insular involvement was associated with cardioembolic stroke (CES) in patients with middle cerebral artery (MCA) infarction. [Methods] The patients with MCA infarction admitted to stroke centers of the First Affiliated Hospital, Sun Yat-sen University, and the First Affiliated Hospital of Guangxi Medical University, from October 2020 to March 2023 were included retrospectively. Stroke etiologies were classified into cardioembolic and noncardioembolic subtypes. Insular involvement was determined mainly using diffusion-weighted magnetic resonance imaging (DWI). Univariate and multivariate logistic regression analyses were performed to evaluate the association between insular involvement and CES. [Results] Of 1585 patients enrolled, stroke etiologies were cardioembolic subtype in 173 (10.9%) and noncardioembolic subtype in 1412 (89.1%). Insular involvement was found in 448 cases (28.3%). Among these cases, 135 (78.0%) were found in the cardioembolic group, and 313 (22.2%) in the noncardioembolic group. Univariate analysis demonstrated that insular involvement was associated with CES (unadjusted odds ratio [OR], 12.474; 95% confidence interval [CI], 8.520~18.263, P<0.001). After adjusting for potential confounders, this association remained significant (model 3: OR, 6.233; 95%CI,3.688~10.534, P<0.001). Such associations were also observed in patients with left (model 3: OR, 4.977;95%CI 2.758~8.987, P<0.001) or right insular involvement (model 3: OR, 4.998; 95%CI 2.743~9.107, P<0.001). [Conclusions] Insular involvement after MCA infarction may be a potential neuroimaging biomarker of CES.
Authors and Affiliations
Baozi HUANG, Jianle LI, Pingping LI, Suhan CAO, Chunyong CHEN, Zimu JIANG, Jinsheng. ZENG
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