Is the TOAST Classification Suitable for Use in Personalized Medicine in Ischemic Stroke?
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Examinations
2.3. Magnetic Resonance Imaging
2.4. Carotid Ultrasound
2.5. Ankle–Brachial Index
2.6. Reactive Hyperemia Index
2.7. Statistical Analyses
3. Results
Vascular Parameters Related to TOAST Groups
4. Discussion
Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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All Patients | Large Artery Atherosclerosis | Cardio-Embolism | Small Vessel Occlusion | Other Determined Etiology | Undetermined Etiology | p-Value | |
---|---|---|---|---|---|---|---|
n = 99 | n = 14 | n = 16 | n = 28 | n = 2 | n = 39 | ||
Age, years | 68 (36–88) | 68 (45–81) | 73 (36–83) | 71 (47–88) | 52 (51–52) | 68 (41–85) | 0.082 |
Sex | 0.017 | ||||||
Men | 55 (55.6) | 5 (35.7) | 9 (56.2) | 11 (39.3) | 1 (50.0) | 29 (74.4) | |
Woman | 44 (44.4) | 9 (64.3) | 7 (43.8) | 17 (60.7) | 1 (50.0) | 10 (25.6) | |
mRS | 2 (0–5) | 2 (0–4) | 1 (0–4) | 2 (0–4) | 2 (2–2) | 2 (0–5) | 0.52 |
NIHSS | 2 (0–16) | 2 (0–13) | 1 (0–13) | 2 (0–9) | 2 (1–3) | 2 (0–16) | 0.39 |
Comorbidities | |||||||
Hyper-tension | 59 (59.6) | 6 (42.9) | 11 (68.8) | 17 (60.7) | 1 (50.0) | 24 (61.5) | 0.67 |
Diabetes type 2 | 20 (20.2) | 2 (14.3) | 6 (37.5) | 4 (14.3) | 0 (0.0) | 8 (20.5) | 0.41 |
Hypercholesterolemia | 60 (60.6) | 10 (71.4) | 9 (56.2) | 19 (67.9) | 1 (50.0) | 21 (53.8) | 0.68 |
Atrial fibrillation | 18 (18.2) | 0 (0.0) | 11 (68.8) | 0 (0.0) | 0 (0.0) | 8 (20.5) | <0.001 |
Former stroke or TIA | 25 (25.3) | 4 (28.6) | 5 (31.2) | 10 (35.7) | 0 (0.0) | 6 (15.4) | 0.32 |
SVD score | n = 89 | n = 14 | n = 13 | n = 25 | n = 2 | n = 35 | 0.59 |
0 | 29 (32.6) | 8 (57.1) | 5 (38.5) | 5 (20.0) | 2 (100.0) | 9 (25.7) | |
1 | 18 (20.2) | 2 (14.3) | 4 (30.8) | 5 (20.0) | 0 (0.0) | 7 (20.0) | |
2 | 19 (21.3) | 3 (21.4) | 2 (15.4) | 8 (32.0) | 0 (0.0) | 6 (17.1) | |
3 | 18 (20.2) | 1 (7.1) | 2 (15.4) | 5 (20.0) | 0 (0.0) | 10 (28.6) | |
4 | 5 (5.6) | 0 (0.0) | 0 (0.0) | 2 (8.0) | 0 (0.0) | 3 (8.6) | |
Carotid examination | n = 94 | n = 11 | n = 16 | n = 27 | n = 2 | n = 38 | |
Carotid stenosis ≥ 50% | 17 (17.2) | 6 (54.5) | 1 (6.3) | 2 (7.4) | 1 (50.0) | 7 (18.4) | 0.023 |
Endothelial dysfunction | n = 90 | n = 12 | n = 13 | n = 26 | n = 2 | n = 37 | |
RHI | 1.89 (0.82–3.81) | 2.21 (1.37–3.81) | 1.85 (1.28–2.42) | 1.83 (0.92–3.80) | 2.21 (1.86–2.55) | 1.90 (0.82–3.35) | 0.37 |
Peripheral arterial disease | n = 89 | n = 12 | n = 14 | n = 24 | n = 2 | n = 37 | |
ABI, mean (SD) | 0.93 (0.18) | 0.99 (0.11) | 0.88 (0.17) | 0.89 (0.19) | 0.81 (0.13) | 0.97 (0.20) | 0.20 |
Renal function | n = 99 | n = 14 | n = 16 | n = 28 | n = 2 | n = 39 | |
eGFR, mL/min/1.73 m2 | 82 (6–116) | 81 (39–116) | 81 (43–102) | 83 (6–102) | 95 (80–109) | 78 (18–105) | 0.79 |
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Simonsen, S.A.; West, A.S.; Heiberg, A.V.; Wolfram, F.; Jennum, P.J.; Iversen, H.K. Is the TOAST Classification Suitable for Use in Personalized Medicine in Ischemic Stroke? J. Pers. Med. 2022, 12, 496. https://doi.org/10.3390/jpm12030496
Simonsen SA, West AS, Heiberg AV, Wolfram F, Jennum PJ, Iversen HK. Is the TOAST Classification Suitable for Use in Personalized Medicine in Ischemic Stroke? Journal of Personalized Medicine. 2022; 12(3):496. https://doi.org/10.3390/jpm12030496
Chicago/Turabian StyleSimonsen, Sofie A., Anders S. West, Adam V. Heiberg, Frauke Wolfram, Poul J. Jennum, and Helle K. Iversen. 2022. "Is the TOAST Classification Suitable for Use in Personalized Medicine in Ischemic Stroke?" Journal of Personalized Medicine 12, no. 3: 496. https://doi.org/10.3390/jpm12030496