Abstract WP204: Patients With Traditional Cerebrovascular Risk Factors Are At A Higher Risk Of Stroke After Cervical Artery Dissection

Aayushi Garg; Enrique C. C Leira; Amir Shaban

doi:10.1161/str.53.suppl_1.WP204

Byline: Aayushi Garg, Univ of Iowa, Iowa City, IA; Enrique C. C Leira; Amir Shaban Background: Ischemic stroke is a common complication of cervical artery dissection (CeAD), however, the factors predisposing to stroke are unclear. We aimed to evaluate the timing and risk factors of ischemic events in patients with CeAD. Methods: We identified hospitalizations with carotid artery dissection (CAD) and vertebral artery dissection (VAD) from the Nationwide Readmissions Database 2016-2018. Multivariable logistic regression and Cox regression analyses were used to evaluate the risk factors associated with ischemic events during the index hospitalization and after hospital discharge, respectively. Results: There were 38824 hospitalizations due to CeAD (meanØSD age: 53.7Ø18.3 years, female: 43.2%); 19769 (50.9%) with acute ischemic stroke (AIS) or transient ischemic attack (TIA) and 19055 (49.1%) without any ischemic events during the initial hospitalization. Advanced age, female sex, both CAD and VAD (in reference to VAD alone), and history of Marfan's syndrome were associated with lower odds of ischemic events. Whereas history of hypertension, hyperlipidemia, diabetes, tobacco use, obesity, and previous stroke/TIA were associated with higher likelihood of ischemic events at initial presentation. Among 32862 index cases with survival to discharge and known discharge disposition, readmission due to acute ischemic events within 1 year of discharge occurred in 924 (2.8%) patients, with meanØSD time to readmission: 56.6Ø70.8 days. The risk of readmission due to ischemic events did not differ by the location of CeAD. However, AIS/TIA during the index hospitalization [hazards ratio (HR): 3.1, 95% confidence interval (CI): 2.5-4.0), history of hyperlipidemia (HR: 1.3, 95% CI: 1.1-1.6), diabetes (HR: 1.5, 95% CI: 1.2-1.8), tobacco use (HR: 1.3, 95% CI: 1.1-1.6), and head/neck vessel atherosclerosis (HR: 1.3, 95% CI: 1.1-1.6) were independently associated with a higher risk of delayed ischemic events. Conclusion: Nearly half of the hospitalized patients with CeAD have ischemic events at initial presentation. Delayed ischemic events are possible, however, occur in a relatively small proportion of patients. Comorbid cerebrovascular risk factors are associated with both concurrent and delayed ischemic events in patients with CeAD.

Abstract WP204: Patients With Traditional Cerebrovascular Risk Factors Are At A Higher Risk Of Stroke After Cervical Artery Dissection

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