Cortical superficial siderosis and recurrent intracerebral hemorrhage risk in cerebral amyloid angiopathy: Large prospective cohort and preliminary meta-analysis
| Autor: | Li Xiong, Marco Pasi, Jonathan Rosand, Kristin Schwab, Steven M. Greenberg, Gregoire Boulouis, Andreas Charidimou, Duangnapa Roongpiboonsopit, Mahmut Edip Gurol, Anand Viswanathan |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Pathology medicine.medical_specialty Neuroimaging 030204 cardiovascular system & hematology Recurrence risk Cohort Studies 03 medical and health sciences 0302 clinical medicine Recurrence Risk Factors medicine Humans cardiovascular diseases Prospective cohort study Aged Cerebral Hemorrhage Intracerebral hemorrhage business.industry medicine.disease Superficial siderosis Magnetic Resonance Imaging Cerebral Amyloid Angiopathy Neurology Meta-analysis Female Cerebral amyloid angiopathy business 030217 neurology & neurosurgery |
| Zdroj: | International journal of stroke : official journal of the International Stroke Society. 14(7) |
| ISSN: | 1747-4949 |
| Popis: | Background We aimed to investigate cortical superficial siderosis as an MRI predictor of lobar intracerebral hemorrhage (ICH) recurrence risk in cerebral amyloid angiopathy (CAA), in a large prospective MRI cohort and a systematic review. Methods We analyzed a single-center MRI prospective cohort of consecutive CAA-related ICH survivors. Using Kaplan–Meier and Cox regression analyses, we investigated cortical superficial siderosis and ICH risk, adjusting for known confounders. We pooled data with eligible published cohorts in a two-stage meta-analysis using random effects models. Covariate-adjusted hazard rations (adj-HR) from pre-specified multivariable Cox proportional hazard models were used. Results The cohort included 240 CAA-ICH survivors (cortical superficial siderosis prevalence: 36%). During a median follow-up of 2.6 years (IQR: 0.9–5.1 years) recurrent ICH occurred in 58 patients (24%). In prespecified multivariable Cox regression models, cortical superficial siderosis presence and disseminated cortical superficial siderosis were independent predictors of increased symptomatic ICH risk at follow-up (HR: 2.26; 95% CI: 1.31–3.87, p = 0.003 and HR: 3.59; 95% CI: 1.96–6.57, p Conclusions In CAA-ICH patients, cortical superficial siderosis presence and extent are the most important MRI prognostic risk factors for lobar ICH recurrence. These results can help guide clinical decision making in patients with CAA. |
| Databáze: | OpenAIRE |
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