Research For The Clinical Differences Between CISS Subtypes Of Branch Atheromatous Disease

Objectives Based on China Ischemic Stroke Subclassification, we analyzed the clinical differences between Branch atherosclerosis Disease (Branch Atheromatous diseases, BAD) and non-BAD, between various subtypes of BAD?Methods The records of 146 acute ischemic stroke patients who underwent high-resolution magnetic resonance imaging (HR-MRI) were retrospected. After the selection,80 patients were enrolled in our research, including 45 BAD cases and 35 non-BAD cases. The clinical differences of the two groups were analyzed, and the correlation between the factors and the groups was evaluated by stepwise regression analysis. Based on CISS, combined with HR-MRI image, BAD cases and non-BAD cases were classified into 4 groups:BAD-LAA, BAD-PAD, non-BAD-LAA, non-BAD-PAD, The clinical differences of the four groups were analyzed, and the correlation between the factors and the two groups was evaluated by stepwise regression analysis. Further more, depending on the location of the infarction lesions, BAD cases were classified into 4 groups:BAD-LSA-LAA, BAD-LSA-PAD, BAD-PPA-LAA, BAD-PPA-PAD, The clinical differences of the four groups were analyzed.Results In the comparison between BAD and non-BAD, risk factors did not present significant differences, the initial NIHSS scores of BAD were higher than non-BAD, the risk of BAD were found 4.928 higher than non-BAD for smokes (P=0.021). In the comparison between BAD-LAA and BAD-PAD, BAD-LAA were found occupied the most of BAD cases (71.11%), risk factors and clinical characteristics did not present significant differences, the risk of BAD-LAA were found 10.20 higher than BAD-PAD for smokes (P=0.048), the risk of BAD-PAD were found 16.411 higher than BAD-LAA for diabetes mellitus patients (P=0.014). In the comparison between BAD-LAA and non-BAD-LAA, morbidity of diabetes mellitus in BAD-LAA groups was found lower than non-BAD-LAA (18.8% vs 47.6%, P=0.048), risk factors and clinical characteristics did not present significant differences, clinical characteristics did not present significant differences, the risk of BAD-LAA were found 15.97 higher than non-BAD-LAA for smokes (P=0.014), the risk of non-BAD-LAA were found 7.042 higher than BAD-LAA for diabetes mellitus patients (P=0.039). In the comparison between BAD-PAD and non-BAD-PAD, non-BAD-PAD patents were found older than BAD-PAD patents (66.64±11.08 vs 55.31±15.86, P=0.040), and had lower initial NIHSS scores than BAD-PAD patents (5.38±2.99 vs 2.14±1.70, P<0.001). In paired comparison of BAD-LSA-LAA, BAD-LSA-PAD, BAD-PPA-LAA and BAD-PPA-PAD, only the LDL of BAD-LSA-PAD were higher than BAD-PPA-PAD (3.79±0.77 vs 2.57±0.96, P=0.028), other risk factors and clinical characteristics did not present significant differences.Conclusions The clinical characteristics showed homogeneity not only between the CISS subtypes of BAD, but also between the LAA subtype of BAD and LAA subtype of non-BAD. In PAD subtypes, the effects of different etiologies on clinical characteristics were different. BAD is a special type of cerebral infarction. On the basis of CISS system, the risk factors and clinical characteristics BAD was closed to LAA. PAD accounted for about a third of all BAD. The risk factors and clinical characteristics among BAD subgroups showed homogeneity. The risk factors and clinical characteristics between BAD cases in the same location with similar pathological changes on different grades artery and cases in the different location with similar pathological changes on similar grades artery showed homogeneity.