Document Type
Article
Publication 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.
Recommended Citation
Musmar, Basel; Roy, Joanna; Abdalrazeq, Hammam; Atallah, Elias; Naamani, Kareem El; Chen, Ching-Jen; Jabre, Roland; Saad, Hassan; Grossberg, Jonathan; Dmytriw, Adam; Patel, Aman; Khorasanizadeh, Mirhojjat; Ogilvy, Christopher; Thomas, Ajith; Monteiro, Andre; Siddiqui, Adnan; Cortez, Gustavo; Hanel, Ricardo; Porto, Guilherme; Spiotta, Alejandro; Piscopo, Anthony; Hasan, David; Ghorbani, Mohammad; Weinberg, Joshua; Nimjee, Shahid; Bekelis, Kimon; Salem, Mohamed; Burkhardt, Jan-Karl; Zetchi, Akli; Matouk, Charles; Howard, Brian; Lai, Rosalind; Du, Rose; Abbas, Rawad; Sioutas, Georgios; Amllay, Abdelaziz; Munoz, Alfredo; Herial, Nabeel; Tjoumakaris, Stavropoula; Gooch, Michael; Rosenwasswer, Robert; and Jabbour, Pascal, "The Impact of Hypertension on Clinical Outcomes in Moyamoya Disease: A Multicenter, Propensity Score-Matched Analysis" (2024). Department of Neurosurgery Faculty Papers. Paper 241.
https://jdc.jefferson.edu/neurosurgeryfp/241
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
PubMed ID
39269654
Language
English
Included in
Cardiovascular Diseases Commons, Health Services Research Commons, Nervous System Diseases Commons, Neurosurgery Commons
Comments
This article is the author's final published version in Acta Neurochirurgica, Volume 166, Issue 1, 2024, Article number 366.
The published version is available at https://doi.org/10.1007/s00701-024-06254-0.
Copyright © The Author(s) 2024