{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:25:58Z","timestamp":1792081558455,"version":"4.4.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Purpose:<\/jats:title>\n                    <jats:p>While prior studies identified risk factors for recurrent stroke in patients with symptomatic intracranial atherosclerotic disease, few have assessed risk factors for early infarct recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed a post hoc analysis of the MYRIAD study (Mechanisms of Early Recurrence in Intracranial Atherosclerotic Disease) of intracranial atherosclerotic disease patients with recent (&lt;21 days) stroke\/transient ischemic attack, 50% to 99% stenosis and who underwent 6- to 8-week magnetic resonance imaging (MRI) per protocol. Infarct recurrence was defined as new infarcts in the territory of the symptomatic artery on brain MRI at 6 to 8 weeks compared to index brain MRI. Qualifying events and clinical and imaging outcomes were centrally ascertained by 2 independent reviewers. We assessed the association between baseline clinical and imaging variables and recurrent infarct in bivariate models and multivariable logistic regression to identify independent predictors of infarct recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 105 enrolled patients in MYRIAD, 89 (84.8%) were included in this analysis (mean age, 64\u00b112 years, 54 [60.7%] were male, and 53 [59.6%] were White). The median time from qualifying event to MRI was 51+16 days, on which 22 (24.7%) patients had new or recurrent infarcts. Younger age (57.7 versus 66.0 years;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.01), diabetes (32.6% versus 14.6%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.05), index stroke (31.3% versus 4.6%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.01), anterior circulation location of stenosis (29.7% versus 12.0%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.08), number of diffusion-weighted imaging lesions (&gt;1: 40.0%, 1: 26.9% versus 0: 4.4%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.01), and borderzone infarct pattern (63.6% versus 25.0%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.01) on baseline MRI were associated with new or recurrent infarcts. Age (adjusted odds ratio, 0.93 [95% CI, 0.89\u20130.98],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.01) and number of diffusion-weighted imaging lesions (adjusted odds ratio, 3.24 [95% CI, 1.36\u20137.71],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.01) were independently associated with recurrent infarct adjusting for hypertension, diabetes, and stenosis location (anterior versus posterior circulation).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>An index multi-infarct pattern is associated with early recurrent infarcts, a finding that might be explained by plaque instability and artery-to-artery embolism. Further investigation of plaque vulnerability in intracranial atherosclerotic disease is needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT02121028.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.120.032676","type":"journal-article","created":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T05:03:03Z","timestamp":1618808583000},"page":"1961-1966","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":50,"title":["Predictors of Early Infarct Recurrence in Patients With Symptomatic Intracranial Atherosclerotic Disease"],"prefix":"10.1161","volume":"52","clinical-trial-number":[{"clinical-trial-number":"nct02121028","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0724-1694","authenticated-orcid":true,"given":"Shyam","family":"Prabhakaran","sequence":"first","affiliation":[{"name":"Department of Neurology, The University of Chicago, IL (S.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5109-8736","authenticated-orcid":true,"given":"David S.","family":"Liebeskind","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of California at Los Angeles (D.S.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Cotsonis","sequence":"additional","affiliation":[{"name":"Department of Bioinformatics and Biostatistics, Emory University, Atlanta, GA (G.C., A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azhar","family":"Nizam","sequence":"additional","affiliation":[{"name":"Department of Bioinformatics and Biostatistics, Emory University, Atlanta, GA (G.C., A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Feldmann","sequence":"additional","affiliation":[{"name":"Department of Neurology, The University of Massachusetts Medical School-Baystate, Springfield (E.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajbeer S.","family":"Sangha","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Alabama at Birmingham (R.S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4166-0844","authenticated-orcid":true,"given":"Iszet","family":"Campo-Bustillo","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Miami, FL (I.C.-B., J.G.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3667-2792","authenticated-orcid":true,"given":"Jose G.","family":"Romano","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Miami, FL (I.C.-B., J.G.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the MYRIAD Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1105335"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043033"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.1693"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.105504"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.659185"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.64.1.50"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-019-09534-3"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.105051"},{"key":"e_1_3_5_10_2","first-page":"643","article-title":"A standardized method for measuring intracranial arterial stenosis.","volume":"21","author":"Samuels OB","year":"2000","unstructured":"Samuels, OB, Joseph, GJ, Lynn, MJ, Smith, HA, Chimowitz, MI. 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