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| 1 | Risk stratification in symptomatic intracranial atherosclerotic disease with conventional vascular risk factors and cerebral haemodynamics显示文摘Background and purpose Symptomatic intracranial atherosclerotic stenosis(sICAS)is associated with a considerable risk of recurrent stroke despite contemporarily optimal medical treatment.Severity of luminal stenosis in sICAS and its haemodynamic significance quantified with computational fluid dynamics(CFD)models were associated with the risk of stroke recurrence.We aimed to develop and compare stroke risk prediction nomograms in sICAS,based on vascular risk factors and these metrics.Methods Patients with 50%-99%sICAS confirmed in CT angiography(CTA)were enrolled.Conventional vascular risk factors were collected.Severity of luminal stenosis in sICAS was dichotomised as moderate(50%-69%)and severe(70%-99%).Translesional pressure ratio(PR)and wall shear stress ratio(WSSR)were quantified via CTA-based CFD modelling;the haemodynamic status of sICAS was classified as normal(normal PR&WSSR),intermediate(otherwise)and abnormal(abnormal PR&WSSR).All patients received guideline-recommended medical treatment.We developed and compared performance of nomograms composed of these variables and independent predictors identified in multivariate logistic regression,in predicting the primary outcome,recurrent ischaemic stroke in the same territory(SIT)within 1 year.Results Among 245 sICAS patients,20(8.2%)had SIT.The D2H2A nomogram,incorporating diabetes,dyslipidaemia,haemodynamic status of sICAS,hypertension and age≥50 years,showed good calibration(P for Hosmer-Lemeshow test=0.560)and discrimination(C-statistic 0.73,95%CI 0.60 to 0.85).It also had better performance in risk reclassification and provided larger net benefits in decision curve analysis,compared with nomograms composed of conventional vascular risk factors only,and plus the severity of luminal stenosis in sICAS.Sensitivity analysis in patients with anterior-circulation sICAS showed similar results.Conclusions The D2H2A nomogram,incorporating conventional vascular risk factors and the haemodynamic significance of sICAS as assessed in CFD models,could be a useful tool to stratify sICAS patients for the risk of recurrent stroke under contemporarily optimal medical treatment. | Xuan Tian Hui Fang Linfang Lan Hing Lung Ip Jill Abrigo Haipeng Liu Lina Zheng Florence S Y Fan Sze Ho Ma Bonaventure Ip Bo Song Yuming Xu Jingwei Li Bing Zhang Yun Xu Yannie O Y Soo Vincent Mok Ka Sing Wong Thomas W Leung Xinyi Leng | 2023 | Stroke & Vascular Neurology2023，8，1： | 2 |
| 2 | Influence of phase purity on the in vivo response to hydroxyapatite 显示文摘 | Hing KA Gibson IR Revell PA | 2000 | Bioceramics2000，，： | 1 |
| 3 | Comparative performance of three ceramic bone graft substitutes显示文摘 | Hing KA Wilson LF Buekland T | 2007 | Spine J2007，7，4： | 1 |
| 4 | Characterization of porous hydroxyapatite显示文摘 | Hing KA Best SM Bonfield W | 1999 | J Mater Sci Mater Med1999，10，3： | 1 |
| 5 | Comparative performance of three ceramic bone graft substitutes 显示文摘 | Hing KA Wilson LF Buekland T | 2007 | Spine J2007，7，4： | 1 |
| 6 | Bone repair in the twenty-first century: biology,chemistry or engineering显示文摘 | Hing KA | | 0，，1825： | 1 |
| 7 | Quantification of bone ingrowth within bone-derived porous hydroxyapatite implants of varying density 显示文摘 | Hing KA Best SM Tanner KE | 1999 | J Mater Sci Mater Med1999，10，： | 1 |
| 8 | Bone repair in the twenty-first century:biology,chemistry or engineering显示文摘 | Hing KA | | 0，，1825： | 1 |
| 9 | Porosity variation in hydroxyapatite and osteoblast morphology: a scanning electron microscopy study显示文摘 | Annaz B Hing KA Kayser MV | 2004 | J Microsc2004，，： | 1 |
| 10 | Mediation of bone ingrowth in porous hydroxyapatite bone graft substitutes显示文摘 | Hing KA Best SM Tanner KE | 2004 | J Biomed Mater Res A2004，68，1： | 1 |
| 11 | Bone repair in the twenty-first century:biology,chemistry or engineering显示文摘 | Hing KA | | 0，，1825： | 1 |
| 12 | Effects of silicon level on rate, quality and progession of bone healing within silicate-substituted porous hydroxyapatite scaffolds 显示文摘 | Hing KA Revell PA Smith N | 2006 | Biomaterials2006，27，29： | 1 |
| 13 | Comparative performance of three eeramie bone graft substitutes显示文摘 | Hing KA Wilson LF Buckland T | 2007 | Spine2007，4，： | 1 |
| 14 | Effect of silicon level on rate,quality and progression of bone healing within silicate-substituted porous hydroxyapatite scaffolds显示文摘 | Hing KA Revel PA Smith N | | 0，，29： | 1 |
| 15 | Comparative performance of three ceramic bone graft substitutes显示文摘 | Hing KA Wilson LF Buckland T | | 0，，04： | 1 |
| 16 | Effect of increased strut porosity of calcium phosphate bone graft substitute biomaterials on osteoinduction显示文摘 | Coathup MJ Hing KA Samizadeh S | | 0，，06： | 1 |
| 17 | Development of a hydroxyapatite coating containing silver for the prevention of peri-prosthetic infection 显示文摘 | Ghani Y Coathup M J Hing KA | 2012 | J Orthop Res2012，30，3： | 1 |
| 18 | Comparative performance of three ceramic bone graft substitutes显示文摘 | Hing KA Wilson LF Buckland T | | 0，，： | 1 |
| 19 | Surface charge and the effect of excess calcium ions on the hydroxyapatite surface显示文摘 | Harding IS Rashid N Hing KA | 2005 | Biomaterials2005，26，34： | 1 |
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