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Background: Stroke recurrence is an important factor affecting the prognosis of mechanical thrombectomy in patients with middle cerebral artery (MCA) occlusion. This study aims to construct a model for evaluating the degree of stroke recurrence and conduct binary and ternary interaction analysis.
Method: We conducted a retrospective analysis of the clinical data of stroke recurrence patients, collecting demographic data, clinical characteristics, treatment factors, and biochemical indicators. Use XGBoost and RF models to screen features that contribute significantly to the degree of recurrence, and evaluate model performance through indicators such as ROC curve, F1 score, accuracy, and recall. Construct a stroke recurrence evaluation model based on the common features selected from these two models. Use the Andersson model to analyze the binary interaction between the model and other factors. Further analyze the three-way interaction between the model and other factors.
Result: Both XGBoost and RF models perform well. In the multivariate logistic regression analysis, the recurrence model showed that age, smoking history, and infarct size had a significant impact on the degree of stroke recurrence (OR = 1.006, 1.214, 1.167, all < 0.05), and the constructed recurrence model had a significant effect on the degree of stroke recurrence (OR = 1.346, = 0.047). Through binary interaction analysis, it was found that there was a significant antagonistic effect between the recurrence model and age, smoking history, and infarct size. Triple interaction analysis showed that the synergistic effect of the recurrence model with age and smoking history was significant, and the synergistic effect of the recurrence model with smoking history and infarct size was also significant.
Conclusion: Age, smoking history, and infarct size are important influencing factors on the degree of stroke recurrence in MCA occlusion patients after mechanical thrombectomy treatment. The recurrence model performs differently in different patient populations, and the interaction with age, smoking history, and infarct size is of great significance for evaluating the degree of stroke recurrence.
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http://dx.doi.org/10.3389/fneur.2025.1580950 | DOI Listing |
Stroke
September 2025
Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University.
Background: Risk stratification in posterior circulation ischemic stroke (PCIS) is challenging. Although the Posterior Circulation Ischemic Stroke Outcome Score (PCISOS) was developed to address this, its utility in minor PCIS and in identifying homogeneous populations for clinical trials or treatment-responsive subgroups remains uncertain.
Methods: CHANCE-2 (Clopidogrel in High-Risk Patients With Acute Non-disabling Cerebrovascular Events-II) was a multicenter, randomized trial that enrolled patients with minor stroke or high-risk transient ischemic attack who carried CYP2C19 loss-of-function alleles.
Eur J Case Rep Intern Med
August 2025
Department of Internal Medicine, Dubai Hospital, Dubai Health, Dubai, Dubai, United Arab Emirates.
Introduction: Primary central nervous system vasculitis (primary CNS vasculitis) is a rare inflammatory disorder that affects small-to-medium-sized cerebral vessels, often leading to recurrent strokes. Diagnosis is vague due to non-specific neurological symptoms. Imaging findings, cerebrospinal fluid (CSF) analysis and exclusion of systemic vasculitis are essential for diagnosis.
View Article and Find Full Text PDFRev Cardiovasc Med
August 2025
Center for Coronary Heart Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases of China, State Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037 Beijing, China.
Background: Globally, acute myocardial infarction (AMI) is among the primary causes of mortality. The ideal approach for blood pressure (BP) management for patients experiencing ST-segment elevation myocardial infarction (STEMI) who receive percutaneous coronary intervention (PCI) remains a topic of ongoing debate. Current guidelines on BP management lack specific recommendations for STEMI patients undergoing PCI, resulting in substantial individual variability and uncertainties in clinical treatment strategies.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
September 2025
Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Background: Patent foramen ovale (PFO) has been identified as a potential risk factor for cryptogenic stroke (CS). Although transesophageal echocardiography (TEE) is considered the gold standard for PFO detection, false-negative results remain a clinical concern, particularly in CS patients with high suspicion of PFO-related etiology.
Aims: To evaluate the clinical utility of transcatheter PFO exploration (TPFOE) in CS patients with negative TEE findings but high suspicion of PFO-related etiology.
JAMA Netw Open
September 2025
Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock.
Importance: Patients with kidney failure (KF) receiving long-term dialysis have increased incidence of atrial fibrillation (AF). Patients with KF and AF have increased risk of stroke, death, and bleeding compared with age-matched cohorts. In KF, the use of oral anticoagulants (OACs) increases hemorrhage risk, offsetting potential benefits and making left atrial appendage occlusion (LAAO) a potentially promising solution for risk reduction in AF.
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