{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T20:26:43Z","timestamp":1792268803188,"version":"4.4.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Infarct growth rate is remarkably heterogeneous in acute ischemic stroke, reflecting diverse clinical-physiological phenotypes. We compared different methods of estimating infarct growth rate in patients with acute ischemic stroke undergoing thrombectomy using multimodal computed tomography (CT) stroke imaging.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>Secondary analysis of the international ESCAPE-NA1 trial (Efficacy and Safety of Nerinetide for the Treatment of Acute Ischemic Stroke) which evaluated the effect of nerinetide in patients with large vessel occlusion undergoing thrombectomy. Infarct growth rate was estimated leveraging each component of multimodal stroke CT imaging: (1) 10 minus baseline Alberta Stroke Program Early CT Score (ASPECTS) divided by hours elapsed from symptom onset on noncontrast CT (ASPECTS decay per hour); (2) collateral status on multiphase CT angiography (mCTA), and (3) hypoperfusion intensity ratio on CT perfusion. Patients were dichotomized into intermediate and slow progressors (since fast progressors were likely to be excluded from ESCAPE-NA1 based on trial enrollment criteria) according to median ASPECTS decay, presence of good versus moderate\/poor mCTA collaterals, and median hypoperfusion intensity ratio, respectively. Associations between progressor phenotypes and 90-day modified Rankin Scale score were assessed across neuroimaging modalities using adjusted logistic regression analyses.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>Among 1105 patients enrolled in ESCAPE-NA1 between 2017 and 2019, 619 (56.0%) were assessed for progressor phenotypes using noncontrast CT, 1084 (98.1%) with mCTA, and 415 (37.6%) with CT perfusion. Median ASPECTS decay per hour was 1.05 (interquartile range, 0.05\u20131.85), 188\/1084 (17%) patients had good collateral status on mCTA, and the median hypoperfusion intensity ratio was 0.44 (interquartile range, 0.28\u20130.59). Intermediate progressors showed worse functional outcomes compared with slow progressors only in CT perfusion strata: adjusted common odds ratio for modified Rankin Scale ordinal shift analysis of 1.69 (95% CI, 1.14\u20132.49). No significant association between progressor phenotypes and 90-day modified Rankin Scale was seen when the noncontrast CT and the mCTA approaches were used.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Stroke progressor phenotypes based on CT perfusion criteria (using the hypoperfusion intensity ratio approach) were associated with clinical outcomes, while stroke progressor phenotypes based on noncontrast CT (ASPECTS decay) and mCTA (collateral status) criteria were not.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.124.047680","type":"journal-article","created":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T05:01:21Z","timestamp":1739163681000},"page":"657-666","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Comparison of Noncontrast Computed Tomography, Multiphase Computed Tomography Angiography, and Computed Tomography Perfusion to Assess Infarct Growth Rate in Acute Stroke"],"prefix":"10.1161","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4042-4735","authenticated-orcid":true,"given":"Umberto","family":"Pensato","sequence":"first","affiliation":[{"name":"IRCCS Humanitas Research Hospital, Milan, Italy (U.P.)."},{"name":"Department of Biomedical Sciences, Humanitas University, Milan, Italy (U.P.)."},{"name":"Calgary Stroke Program, Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Alberta, Canada (U.P., S.L.B., A.S., M.D.H., A.M.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7570-8723","authenticated-orcid":true,"given":"Salome L.","family":"Bosshart","sequence":"additional","affiliation":[{"name":"Calgary Stroke Program, Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Alberta, Canada (U.P., S.L.B., A.S., M.D.H., A.M.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8895-0894","authenticated-orcid":true,"given":"Alexander","family":"Stebner","sequence":"additional","affiliation":[{"name":"Calgary Stroke Program, Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Alberta, Canada (U.P., S.L.B., A.S., M.D.H., A.M.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1379-3612","authenticated-orcid":true,"given":"Dar","family":"Dowlatshahi","sequence":"additional","affiliation":[{"name":"Department of Medicine (Neurology), University of Ottawa and Ottawa Hospital Research Institute, Ontario, Canada (D.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7962-8751","authenticated-orcid":true,"given":"Oh Young","family":"Bang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea (O.Y.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7986-3305","authenticated-orcid":true,"given":"Demetrios J.","family":"Sahlas","sequence":"additional","affiliation":[{"name":"McMaster University, Hamilton, Ontario, Canada (D.J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1176-0633","authenticated-orcid":true,"given":"Thalia S.","family":"Field","sequence":"additional","affiliation":[{"name":"Vancouver Stroke Program, Division of Neurology, University of British Columbia, Canada (T.S.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1415-3027","authenticated-orcid":true,"given":"Volker","family":"Puetz","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Carl Gustav Carus an der Technischen Universit\u00e4t Dresden, Germany (V.P.)."},{"name":"Dresden Neurovascular Center, University Hospital Carl Gustav Carus an der Technische Universit\u00e4t Dresden, Germany (V.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7984-6062","authenticated-orcid":true,"given":"Brian H.","family":"Buck","sequence":"additional","affiliation":[{"name":"University of Alberta Hospital, Edmonton, Canada (B.H.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6269-1543","authenticated-orcid":true,"given":"Michael D.","family":"Hill","sequence":"additional","affiliation":[{"name":"Calgary Stroke Program, Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Alberta, Canada (U.P., S.L.B., A.S., M.D.H., A.M.D.)."},{"name":"Department of Radiology, University of Calgary Cumming School of Medicine, Alberta, Canada (M.D.H., M.G., J.M.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9060-2109","authenticated-orcid":true,"given":"Mayank","family":"Goyal","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Calgary Cumming School of Medicine, Alberta, Canada (M.D.H., M.G., J.M.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4930-7789","authenticated-orcid":true,"given":"Andrew M.","family":"Demchuk","sequence":"additional","affiliation":[{"name":"Calgary Stroke Program, Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Alberta, Canada (U.P., S.L.B., A.S., M.D.H., A.M.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0029-6764","authenticated-orcid":true,"given":"Johanna M.","family":"Ospel","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Calgary Cumming School of Medicine, Alberta, Canada (M.D.H., M.G., 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