The impact of hypertension on clinical outcomes in moyamoya disease: a multicenter, propensity score-matched analysis.
Publication/Presentation Date
9-13-2024
Abstract
BACKGROUND: Moyamoya disease (MMD) is a rare cerebrovascular disorder characterized by progressive steno-occlusive changes in the internal carotid arteries, leading to an abnormal vascular network. Hypertension is prevalent among MMD patients, raising concerns about its impact on disease outcomes. This study aims to compare the clinical characteristics and outcomes of MMD patients with and without hypertension.
METHODS: We conducted a multicenter, retrospective study involving 598 MMD patients who underwent surgical revascularization across 13 academic institutions in North America. Patients were categorized into hypertensive (n=292) and non-hypertensive (n=306) cohorts. Propensity score matching (PSM) was performed to adjust for baseline differences.
RESULTS: The mean age was higher in the hypertension group (46 years vs. 36.8 years, p < 0.001). Hypertensive patients had higher rates of diabetes mellitus (45.2% vs. 10.7%, p < 0.001) and smoking (48.8% vs. 27.1%, p < 0.001). Symptomatic stroke rates were higher in the hypertension group (16% vs. 7.1%; OR: 2.48; 95% CI: 1.39-4.40, p = 0.002) before matching. After PSM, there were no significant differences in symptomatic stroke rates (11.1% vs. 7.7%; OR: 1.5; CI: 0.64-3.47, p = 0.34), perioperative strokes (6.2% vs. 2.1%; OR 3.13; 95% CI: 0.83-11.82, p = 0.09), or good functional outcomes at discharge (93% vs. 92.3%; OR 1.1; 95% CI: 0.45-2.69, p = 0.82).
CONCLUSION: No significant differences in symptomatic stroke rates, perioperative strokes, or functional outcomes were observed between hypertensive and non-hypertensive Moyamoya patients. Appropriate management can lead to similar outcomes in both groups. Further prospective studies are required to validate these findings.
Volume
166
Issue
1
First Page
366
Last Page
366
ISSN
0942-0940
Published In/Presented At
Musmar, B., Roy, J. M., Abdalrazeq, H., Atallah, E., Naamani, K. E., Chen, C. J., Jabre, R., Saad, H., Grossberg, J. A., Dmytriw, A. A., Patel, A. B., Khorasanizadeh, M., Ogilvy, C. S., Thomas, A. J., Monteiro, A., Siddiqui, A., Cortez, G. M., Hanel, R. A., Porto, G., Spiotta, A. M., … Jabbour, P. (2024). The impact of hypertension on clinical outcomes in moyamoya disease: a multicenter, propensity score-matched analysis. Acta neurochirurgica, 166(1), 366. https://doi.org/10.1007/s00701-024-06254-0
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
39269654
Department(s)
Administration and Leadership
Document Type
Article