Limits...
Total Cerebral Small-Vessel Disease Score is Associated with Mortality during Follow-Up after Acute Ischemic Stroke

View Article: PubMed Central - PubMed

ABSTRACT

Background and purpose: The recently developed total cerebral small-vessel disease (CSVD) score might appropriately reflect the total burden or severity of CSVD. We investigated whether the total CSVD score is associated with long-term outcomes during follow-up in patients with acute ischemic stroke.

Methods: In total, 1,096 consecutive patients with acute ischemic stroke who underwent brain magnetic resonance imaging were enrolled. We calculated the total CSVD score for each patient after determining the burden of cerebral microbleeds (CMBs), high-grade white-matter hyperintensities (HWHs), high-grade perivascular spaces (HPVSs), and asymptomatic lacunar infarctions (ALIs). We recorded the date and cause of death for all of the patients using data from the Korean National Statistical Office. We compared the long-term mortality rate with the total CSVD score using Cox proportional-hazards models.

Results: CMBs were found in 26.8% of the subjects (294/1,096), HWHs in 16.4% (180/1,096), HPVSs in 19.3% (211/1,096), and ALIs in 38.0% (416/1,096). After adjusting for age, sex, and variables that were significant at p<0.1 in the univariate analysis, the total CSVD score was independently associated with long-term death from all causes [hazard ratio (HR)=1.18 per point, 95% confidence interval (CI)=1.07–1.30], ischemic stroke (HR=1.20 per point, 95% CI=1.01–1.42), and hemorrhagic stroke (HR=2.05 per point, 95% CI=1.30–3.22), but not with fatal cardiovascular events (HR=1.17 per point, 95% CI=0.82–1.67).

Conclusions: The total CSVD score is a potential imaging biomarker for predicting mortality during follow-up in patients with acute ischemic stroke.

No MeSH data available.


Related in: MedlinePlus

Selection of patients. GRE: gradient recalled echo, TIA: transient ischemic attack.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC5392462&req=5

Figure 1: Selection of patients. GRE: gradient recalled echo, TIA: transient ischemic attack.

Mentions: We excluded 45 of the 1,215 patients who did not undergo brain MRI due to the patient's refusal, claustrophobia, or presence of metallic material in the body, 23 with no available gradient recalled echo (GRE) images, 20 with poor image quality, and 6 with no vessel imaging data. Patients with stroke due to other determined etiology (n=25) were also excluded. These exclusions resulted in 1,096 patients finally being included in this study (Fig. 1).


Total Cerebral Small-Vessel Disease Score is Associated with Mortality during Follow-Up after Acute Ischemic Stroke
Selection of patients. GRE: gradient recalled echo, TIA: transient ischemic attack.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5392462&req=5

Figure 1: Selection of patients. GRE: gradient recalled echo, TIA: transient ischemic attack.
Mentions: We excluded 45 of the 1,215 patients who did not undergo brain MRI due to the patient's refusal, claustrophobia, or presence of metallic material in the body, 23 with no available gradient recalled echo (GRE) images, 20 with poor image quality, and 6 with no vessel imaging data. Patients with stroke due to other determined etiology (n=25) were also excluded. These exclusions resulted in 1,096 patients finally being included in this study (Fig. 1).

View Article: PubMed Central - PubMed

ABSTRACT

Background and purpose: The recently developed total cerebral small-vessel disease (CSVD) score might appropriately reflect the total burden or severity of CSVD. We investigated whether the total CSVD score is associated with long-term outcomes during follow-up in patients with acute ischemic stroke.

Methods: In total, 1,096 consecutive patients with acute ischemic stroke who underwent brain magnetic resonance imaging were enrolled. We calculated the total CSVD score for each patient after determining the burden of cerebral microbleeds (CMBs), high-grade white-matter hyperintensities (HWHs), high-grade perivascular spaces (HPVSs), and asymptomatic lacunar infarctions (ALIs). We recorded the date and cause of death for all of the patients using data from the Korean National Statistical Office. We compared the long-term mortality rate with the total CSVD score using Cox proportional-hazards models.

Results: CMBs were found in 26.8% of the subjects (294/1,096), HWHs in 16.4% (180/1,096), HPVSs in 19.3% (211/1,096), and ALIs in 38.0% (416/1,096). After adjusting for age, sex, and variables that were significant at p<0.1 in the univariate analysis, the total CSVD score was independently associated with long-term death from all causes [hazard ratio (HR)=1.18 per point, 95% confidence interval (CI)=1.07–1.30], ischemic stroke (HR=1.20 per point, 95% CI=1.01–1.42), and hemorrhagic stroke (HR=2.05 per point, 95% CI=1.30–3.22), but not with fatal cardiovascular events (HR=1.17 per point, 95% CI=0.82–1.67).

Conclusions: The total CSVD score is a potential imaging biomarker for predicting mortality during follow-up in patients with acute ischemic stroke.

No MeSH data available.


Related in: MedlinePlus