Association of white matter hyperintensity markers on MRI and long-term risk of mortality and ischemic stroke the SMART-MR study
| Autor: | Ghaznawi, R., Geerlings, M.I., Jaarsma-Coes, M., Hendrikse, J., Bresser, J. de, UCC-Smart Study Grp |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
0301 basic medicine medicine.medical_specialty Article Brain Ischemia 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine Risk of mortality Humans Aged Ischemic Stroke business.industry Proportional hazards model Hazard ratio Leukoaraiosis Middle Aged Magnetic Resonance Imaging White Matter Confidence interval Stroke Long term risk Cerebrovascular Disorders 030104 developmental biology White matter hyperintensity Automated algorithm Ischemic stroke Cardiology Female Neurology (clinical) business Biomarkers 030217 neurology & neurosurgery |
| Zdroj: | Neurology, 96(17), E2172-E2183. LIPPINCOTT WILLIAMS & WILKINS Neurology article-version (Version of Record) 3 |
| Popis: | ObjectiveTo determine whether white matter hyperintensity (WMH) markers on MRI are associated with long-term risk of mortality and ischemic stroke.MethodsWe included consecutive patients with manifest arterial disease enrolled in the Second Manifestations of Arterial Disease–Magnetic Resonance (SMART-MR) study. We obtained WMH markers (volume, type, and shape) from brain MRI scans performed at baseline using an automated algorithm. During follow-up, occurrence of death and ischemic stroke was recorded. Using Cox regression, we investigated associations of WMH markers with risk of mortality and ischemic stroke, adjusting for demographics, cardiovascular risk factors, and cerebrovascular disease.ResultsWe included 999 patients (59 ± 10 years; 79% male) with a median follow-up of 12.5 years (range 0.2–16.0 years). A greater periventricular or confluent WMH volume was independently associated with a greater risk of vascular death (hazard ratio [HR] 1.29, 95% confidence interval [CI] 1.13–1.47) for a 1-unit increase in natural log-transformed WMH volume and ischemic stroke (HR 1.53, 95% CI 1.26–1.86). A confluent WMH type was independently associated with a greater risk of vascular (HR 1.89, 95% CI 1.15-3.11) and nonvascular death (HR 1.65, 95% CI 1.01–2.73) and ischemic stroke (HR 2.83, 95% CI 1.36-5.87). A more irregular shape of periventricular or confluent WMH, as expressed by an increase in concavity index, was independently associated with a greater risk of vascular (HR 1.20, 95% CI 1.05–1.38 per SD increase) and nonvascular death (HR 1.21, 95% CI 1.03–1.42) and ischemic stroke (HR 1.28, 95% CI 1.05–1.55).ConclusionsWMH volume, type, and shape are associated with long-term risk of mortality and ischemic stroke in patients with manifest arterial disease. |
| Databáze: | OpenAIRE |
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