White matter hyperintensities and recurrent stroke risk in patients with stroke with small‐vessel disease
Background and purpose White matter hyperintensities (WMH) are a predictor of stroke among elderly individuals. This study aimed to evaluate the association between WMH severity and the risk of recurrent vascular events among Asian patients with ischaemic stroke with small‐vessel disease (SVD) inclu...
Gespeichert in:
| Veröffentlicht in: | European journal of neurology 2019-06, Vol.26 (6), p.911-918 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 918 |
|---|---|
| container_issue | 6 |
| container_start_page | 911 |
| container_title | European journal of neurology |
| container_volume | 26 |
| creator | Park, J.‐H. Heo, S. H. Lee, M. H. Kwon, H. S. Kwon, S. U. Lee, J. S. |
| description | Background and purpose
White matter hyperintensities (WMH) are a predictor of stroke among elderly individuals. This study aimed to evaluate the association between WMH severity and the risk of recurrent vascular events among Asian patients with ischaemic stroke with small‐vessel disease (SVD) including micro/macrobleeds and lacunes.
Methods
Data from participants (n = 1454) in the PICASSO (PreventIon of CArdiovascular Events in iSchemic Stroke Patients with High Risk of Cerebral HemOrrhage) trial were reviewed. The severity of WMH in baseline brain magnetic resonance imaging scans was assessed using the Fazekas scale. The association between WMH severity and stroke (ischaemic or hemorrhagic) and major vascular events (MVEs) (a composite of stroke/myocardial infarction/vascular death) was assessed.
Results
Study patients had a significant burden of SVD: Fazekas score 0 (n = 2), 1 (n = 426), 2 (n = 650) and 3 (n = 376) [median Fazekas score 2 (mean follow‐up, 1.9 ± 1.3 years)]. The stroke incidence rate per 100 personyears was 2.6 in the Fazekas 0–1 group, 3.6 in the Fazekas 2 group and 7.0 in the Fazekas 3 group, and the rates for MVEs were 3.3, 4.3 and 7.6, respectively. Compared with the Fazekas 0–1 group, the Fazekas 3 group was associated with a higher risk of stroke [adjusted hazard ratio (HR), 2.15; 95% confidence interval (CI), 1.19–3.88; P = 0.011], ischaemic stroke (adjusted HR, 2.11; 95% CI, 1.07–4.15; P = 0.031), hemorrhagic stroke (adjusted HR, 3.72; 95% CI, 1.09–12.70; P = 0.036) and MVEs (adjusted HR, 2.09; 95% CI, 1.20–3.66; P = 0.010).
Conclusion
Advanced WMH in Asian patients with ischaemic stroke with SVD burden was associated with an increased risk of recurrent vascular events. It may exert an effect as a prognostic indicator in high risk of recurrent vascular events. |
| doi_str_mv | 10.1111/ene.13908 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2179363262</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2179363262</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3538-9bd08150588de977c8d6ca116f932a731a15435236c3d0cd43ffc4ba63a657e83</originalsourceid><addsrcrecordid>eNp10c1u1DAUBWALgWgpLHgBZIkNLNL6-iaOs0TV8CNVsAGxtDzOjcadxBlsp9XseASekSfBkJYFEvbCV_KnI8uHsecgzqGsCwp0DtgJ_YCdQq10BYjwsMzYQNWAgBP2JKVrIYRspXjMTlAobLWWp2z_decz8cnmTJHvjgeKPmQKyWdPidvQ80huiZFC5inHeU88-rTnPvCDLSbkxG993t1frvNkx_Hn9x83lBKNvPeJbKKn7NFgx0TP7s4z9uXt5vPl--rq07sPl2-uKocN6qrb9kJDIxqte-ra1uleOQughg6lbREsNDU2EpXDXri-xmFw9dYqtKppSeMZe7XmHuL8baGUzeSTo3G0geYlGQlthwqlkoW-_Idez0sM5XVGSlA16LKLer0qF-eUIg3mEP1k49GAML8bMKUB86eBYl_cJS7bifq_8v7LC7hYwa0f6fj_JLP5uFkjfwFNzJFR</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2216418181</pqid></control><display><type>article</type><title>White matter hyperintensities and recurrent stroke risk in patients with stroke with small‐vessel disease</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Park, J.‐H. ; Heo, S. H. ; Lee, M. H. ; Kwon, H. S. ; Kwon, S. U. ; Lee, J. S.</creator><creatorcontrib>Park, J.‐H. ; Heo, S. H. ; Lee, M. H. ; Kwon, H. S. ; Kwon, S. U. ; Lee, J. S. ; PICASSO investigators ; the PICASSO investigators</creatorcontrib><description>Background and purpose
White matter hyperintensities (WMH) are a predictor of stroke among elderly individuals. This study aimed to evaluate the association between WMH severity and the risk of recurrent vascular events among Asian patients with ischaemic stroke with small‐vessel disease (SVD) including micro/macrobleeds and lacunes.
Methods
Data from participants (n = 1454) in the PICASSO (PreventIon of CArdiovascular Events in iSchemic Stroke Patients with High Risk of Cerebral HemOrrhage) trial were reviewed. The severity of WMH in baseline brain magnetic resonance imaging scans was assessed using the Fazekas scale. The association between WMH severity and stroke (ischaemic or hemorrhagic) and major vascular events (MVEs) (a composite of stroke/myocardial infarction/vascular death) was assessed.
Results
Study patients had a significant burden of SVD: Fazekas score 0 (n = 2), 1 (n = 426), 2 (n = 650) and 3 (n = 376) [median Fazekas score 2 (mean follow‐up, 1.9 ± 1.3 years)]. The stroke incidence rate per 100 personyears was 2.6 in the Fazekas 0–1 group, 3.6 in the Fazekas 2 group and 7.0 in the Fazekas 3 group, and the rates for MVEs were 3.3, 4.3 and 7.6, respectively. Compared with the Fazekas 0–1 group, the Fazekas 3 group was associated with a higher risk of stroke [adjusted hazard ratio (HR), 2.15; 95% confidence interval (CI), 1.19–3.88; P = 0.011], ischaemic stroke (adjusted HR, 2.11; 95% CI, 1.07–4.15; P = 0.031), hemorrhagic stroke (adjusted HR, 3.72; 95% CI, 1.09–12.70; P = 0.036) and MVEs (adjusted HR, 2.09; 95% CI, 1.20–3.66; P = 0.010).
Conclusion
Advanced WMH in Asian patients with ischaemic stroke with SVD burden was associated with an increased risk of recurrent vascular events. It may exert an effect as a prognostic indicator in high risk of recurrent vascular events.</description><identifier>ISSN: 1351-5101</identifier><identifier>EISSN: 1468-1331</identifier><identifier>DOI: 10.1111/ene.13908</identifier><identifier>PMID: 30637882</identifier><language>eng</language><publisher>England: John Wiley & Sons, Inc</publisher><subject>Blood vessels ; Brain ; Cerebral infarction ; Confidence intervals ; Diuretics ; Geriatrics ; Health risks ; Hemorrhage ; Ischemia ; Magnetic resonance imaging ; Myocardial infarction ; Neuroimaging ; Older people ; recurrent ; Risk ; small‐vessel disease ; Stroke ; Substantia alba ; white matter hyperintensities</subject><ispartof>European journal of neurology, 2019-06, Vol.26 (6), p.911-918</ispartof><rights>2019 EAN</rights><rights>2019 EAN.</rights><rights>Copyright © 2019 European Academy of Neurology</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3538-9bd08150588de977c8d6ca116f932a731a15435236c3d0cd43ffc4ba63a657e83</citedby><cites>FETCH-LOGICAL-c3538-9bd08150588de977c8d6ca116f932a731a15435236c3d0cd43ffc4ba63a657e83</cites><orcidid>0000-0002-2005-0983 ; 0000-0002-2681-1878</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fene.13908$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fene.13908$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30637882$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Park, J.‐H.</creatorcontrib><creatorcontrib>Heo, S. H.</creatorcontrib><creatorcontrib>Lee, M. H.</creatorcontrib><creatorcontrib>Kwon, H. S.</creatorcontrib><creatorcontrib>Kwon, S. U.</creatorcontrib><creatorcontrib>Lee, J. S.</creatorcontrib><creatorcontrib>PICASSO investigators</creatorcontrib><creatorcontrib>the PICASSO investigators</creatorcontrib><title>White matter hyperintensities and recurrent stroke risk in patients with stroke with small‐vessel disease</title><title>European journal of neurology</title><addtitle>Eur J Neurol</addtitle><description>Background and purpose
White matter hyperintensities (WMH) are a predictor of stroke among elderly individuals. This study aimed to evaluate the association between WMH severity and the risk of recurrent vascular events among Asian patients with ischaemic stroke with small‐vessel disease (SVD) including micro/macrobleeds and lacunes.
Methods
Data from participants (n = 1454) in the PICASSO (PreventIon of CArdiovascular Events in iSchemic Stroke Patients with High Risk of Cerebral HemOrrhage) trial were reviewed. The severity of WMH in baseline brain magnetic resonance imaging scans was assessed using the Fazekas scale. The association between WMH severity and stroke (ischaemic or hemorrhagic) and major vascular events (MVEs) (a composite of stroke/myocardial infarction/vascular death) was assessed.
Results
Study patients had a significant burden of SVD: Fazekas score 0 (n = 2), 1 (n = 426), 2 (n = 650) and 3 (n = 376) [median Fazekas score 2 (mean follow‐up, 1.9 ± 1.3 years)]. The stroke incidence rate per 100 personyears was 2.6 in the Fazekas 0–1 group, 3.6 in the Fazekas 2 group and 7.0 in the Fazekas 3 group, and the rates for MVEs were 3.3, 4.3 and 7.6, respectively. Compared with the Fazekas 0–1 group, the Fazekas 3 group was associated with a higher risk of stroke [adjusted hazard ratio (HR), 2.15; 95% confidence interval (CI), 1.19–3.88; P = 0.011], ischaemic stroke (adjusted HR, 2.11; 95% CI, 1.07–4.15; P = 0.031), hemorrhagic stroke (adjusted HR, 3.72; 95% CI, 1.09–12.70; P = 0.036) and MVEs (adjusted HR, 2.09; 95% CI, 1.20–3.66; P = 0.010).
Conclusion
Advanced WMH in Asian patients with ischaemic stroke with SVD burden was associated with an increased risk of recurrent vascular events. It may exert an effect as a prognostic indicator in high risk of recurrent vascular events.</description><subject>Blood vessels</subject><subject>Brain</subject><subject>Cerebral infarction</subject><subject>Confidence intervals</subject><subject>Diuretics</subject><subject>Geriatrics</subject><subject>Health risks</subject><subject>Hemorrhage</subject><subject>Ischemia</subject><subject>Magnetic resonance imaging</subject><subject>Myocardial infarction</subject><subject>Neuroimaging</subject><subject>Older people</subject><subject>recurrent</subject><subject>Risk</subject><subject>small‐vessel disease</subject><subject>Stroke</subject><subject>Substantia alba</subject><subject>white matter hyperintensities</subject><issn>1351-5101</issn><issn>1468-1331</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp10c1u1DAUBWALgWgpLHgBZIkNLNL6-iaOs0TV8CNVsAGxtDzOjcadxBlsp9XseASekSfBkJYFEvbCV_KnI8uHsecgzqGsCwp0DtgJ_YCdQq10BYjwsMzYQNWAgBP2JKVrIYRspXjMTlAobLWWp2z_decz8cnmTJHvjgeKPmQKyWdPidvQ80huiZFC5inHeU88-rTnPvCDLSbkxG993t1frvNkx_Hn9x83lBKNvPeJbKKn7NFgx0TP7s4z9uXt5vPl--rq07sPl2-uKocN6qrb9kJDIxqte-ra1uleOQughg6lbREsNDU2EpXDXri-xmFw9dYqtKppSeMZe7XmHuL8baGUzeSTo3G0geYlGQlthwqlkoW-_Idez0sM5XVGSlA16LKLer0qF-eUIg3mEP1k49GAML8bMKUB86eBYl_cJS7bifq_8v7LC7hYwa0f6fj_JLP5uFkjfwFNzJFR</recordid><startdate>201906</startdate><enddate>201906</enddate><creator>Park, J.‐H.</creator><creator>Heo, S. H.</creator><creator>Lee, M. H.</creator><creator>Kwon, H. S.</creator><creator>Kwon, S. U.</creator><creator>Lee, J. S.</creator><general>John Wiley & Sons, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2005-0983</orcidid><orcidid>https://orcid.org/0000-0002-2681-1878</orcidid></search><sort><creationdate>201906</creationdate><title>White matter hyperintensities and recurrent stroke risk in patients with stroke with small‐vessel disease</title><author>Park, J.‐H. ; Heo, S. H. ; Lee, M. H. ; Kwon, H. S. ; Kwon, S. U. ; Lee, J. S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3538-9bd08150588de977c8d6ca116f932a731a15435236c3d0cd43ffc4ba63a657e83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Blood vessels</topic><topic>Brain</topic><topic>Cerebral infarction</topic><topic>Confidence intervals</topic><topic>Diuretics</topic><topic>Geriatrics</topic><topic>Health risks</topic><topic>Hemorrhage</topic><topic>Ischemia</topic><topic>Magnetic resonance imaging</topic><topic>Myocardial infarction</topic><topic>Neuroimaging</topic><topic>Older people</topic><topic>recurrent</topic><topic>Risk</topic><topic>small‐vessel disease</topic><topic>Stroke</topic><topic>Substantia alba</topic><topic>white matter hyperintensities</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Park, J.‐H.</creatorcontrib><creatorcontrib>Heo, S. H.</creatorcontrib><creatorcontrib>Lee, M. H.</creatorcontrib><creatorcontrib>Kwon, H. S.</creatorcontrib><creatorcontrib>Kwon, S. U.</creatorcontrib><creatorcontrib>Lee, J. S.</creatorcontrib><creatorcontrib>PICASSO investigators</creatorcontrib><creatorcontrib>the PICASSO investigators</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Park, J.‐H.</au><au>Heo, S. H.</au><au>Lee, M. H.</au><au>Kwon, H. S.</au><au>Kwon, S. U.</au><au>Lee, J. S.</au><aucorp>PICASSO investigators</aucorp><aucorp>the PICASSO investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>White matter hyperintensities and recurrent stroke risk in patients with stroke with small‐vessel disease</atitle><jtitle>European journal of neurology</jtitle><addtitle>Eur J Neurol</addtitle><date>2019-06</date><risdate>2019</risdate><volume>26</volume><issue>6</issue><spage>911</spage><epage>918</epage><pages>911-918</pages><issn>1351-5101</issn><eissn>1468-1331</eissn><abstract>Background and purpose
White matter hyperintensities (WMH) are a predictor of stroke among elderly individuals. This study aimed to evaluate the association between WMH severity and the risk of recurrent vascular events among Asian patients with ischaemic stroke with small‐vessel disease (SVD) including micro/macrobleeds and lacunes.
Methods
Data from participants (n = 1454) in the PICASSO (PreventIon of CArdiovascular Events in iSchemic Stroke Patients with High Risk of Cerebral HemOrrhage) trial were reviewed. The severity of WMH in baseline brain magnetic resonance imaging scans was assessed using the Fazekas scale. The association between WMH severity and stroke (ischaemic or hemorrhagic) and major vascular events (MVEs) (a composite of stroke/myocardial infarction/vascular death) was assessed.
Results
Study patients had a significant burden of SVD: Fazekas score 0 (n = 2), 1 (n = 426), 2 (n = 650) and 3 (n = 376) [median Fazekas score 2 (mean follow‐up, 1.9 ± 1.3 years)]. The stroke incidence rate per 100 personyears was 2.6 in the Fazekas 0–1 group, 3.6 in the Fazekas 2 group and 7.0 in the Fazekas 3 group, and the rates for MVEs were 3.3, 4.3 and 7.6, respectively. Compared with the Fazekas 0–1 group, the Fazekas 3 group was associated with a higher risk of stroke [adjusted hazard ratio (HR), 2.15; 95% confidence interval (CI), 1.19–3.88; P = 0.011], ischaemic stroke (adjusted HR, 2.11; 95% CI, 1.07–4.15; P = 0.031), hemorrhagic stroke (adjusted HR, 3.72; 95% CI, 1.09–12.70; P = 0.036) and MVEs (adjusted HR, 2.09; 95% CI, 1.20–3.66; P = 0.010).
Conclusion
Advanced WMH in Asian patients with ischaemic stroke with SVD burden was associated with an increased risk of recurrent vascular events. It may exert an effect as a prognostic indicator in high risk of recurrent vascular events.</abstract><cop>England</cop><pub>John Wiley & Sons, Inc</pub><pmid>30637882</pmid><doi>10.1111/ene.13908</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-2005-0983</orcidid><orcidid>https://orcid.org/0000-0002-2681-1878</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1351-5101 |
| ispartof | European journal of neurology, 2019-06, Vol.26 (6), p.911-918 |
| issn | 1351-5101 1468-1331 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2179363262 |
| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Blood vessels Brain Cerebral infarction Confidence intervals Diuretics Geriatrics Health risks Hemorrhage Ischemia Magnetic resonance imaging Myocardial infarction Neuroimaging Older people recurrent Risk small‐vessel disease Stroke Substantia alba white matter hyperintensities |
| title | White matter hyperintensities and recurrent stroke risk in patients with stroke with small‐vessel disease |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-18T23%3A40%3A59IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=White%20matter%20hyperintensities%20and%20recurrent%20stroke%20risk%20in%20patients%20with%20stroke%20with%20small%E2%80%90vessel%20disease&rft.jtitle=European%20journal%20of%20neurology&rft.au=Park,%20J.%E2%80%90H.&rft.aucorp=PICASSO%20investigators&rft.date=2019-06&rft.volume=26&rft.issue=6&rft.spage=911&rft.epage=918&rft.pages=911-918&rft.issn=1351-5101&rft.eissn=1468-1331&rft_id=info:doi/10.1111/ene.13908&rft_dat=%3Cproquest_cross%3E2179363262%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2216418181&rft_id=info:pmid/30637882&rfr_iscdi=true |