OBJECTIVE: We sought to compare ultra-long-term poststroke survival in small-vessel disease (SVD) vs non-SVD subtype of stroke. METHODS: We followed patients hospitalized with acute ischemic stroke (age 55-85) for 12 years. The diagnosis of SVD was based on the criteria of Trial of Org 10172 in Acute Stroke Treatment. A detailed medical history regarding the relevant risk factors was obtained. Stroke severity was assessed with the modified Rankin Scale (mRS) at 3 months. Influence of the SVD subtype of stroke was analyzed using Kaplan-Meier log-rank analysis with endpoint all-cause death, and Cox regression proportional hazards model was constructed for multivariate analysis. The association between SVD and causes of death (cardiac, brain-related, all other) was analyzed using Kaplan-Meier log-rank analysis. RESULTS: Of the 486 patients, stroke etiology was SVD in 63 patients (13.0%). Median survival was 4.3 years for SVD and 7.9 years for non-SVD (p ≤ 0.001). In the stepwise Cox regression analysis adjusted for relevant confounders, independent predictors of death were SVD (hazard ratio [HR] 1.60, 95% confidence interval [CI] 1.06-2.41), advanced age (HR 1.07, 95% CI 1.05-1.09), stroke severity (mRS 3-5 vs 1-2; HR 2.02, 95% CI 1.58-2.58), smoking (HR 1.44, 95% CI 1.10-1.88), and cardiac failure (HR 1.53, 95% CI 1.14-2.06). SVD was associated with cardiac cause of death (p = 0.021). CONCLUSIONS: In this well-characterized ischemic stroke cohort of patients aged 55-85 years with a 12-year follow-up, acute index stroke attributable to SVD was associated with poorer long-term survival and higher risk for cardiac death than other stroke subtypes.
OBJECTIVE: We sought to compare ultra-long-term poststroke survival in small-vessel disease (SVD) vs non-SVD subtype of stroke. METHODS: We followed patients hospitalized with acute ischemic stroke (age 55-85) for 12 years. The diagnosis of SVD was based on the criteria of Trial of Org 10172 in Acute Stroke Treatment. A detailed medical history regarding the relevant risk factors was obtained. Stroke severity was assessed with the modified Rankin Scale (mRS) at 3 months. Influence of the SVD subtype of stroke was analyzed using Kaplan-Meier log-rank analysis with endpoint all-cause death, and Cox regression proportional hazards model was constructed for multivariate analysis. The association between SVD and causes of death (cardiac, brain-related, all other) was analyzed using Kaplan-Meier log-rank analysis. RESULTS: Of the 486 patients, stroke etiology was SVD in 63 patients (13.0%). Median survival was 4.3 years for SVD and 7.9 years for non-SVD (p ≤ 0.001). In the stepwise Cox regression analysis adjusted for relevant confounders, independent predictors of death were SVD (hazard ratio [HR] 1.60, 95% confidence interval [CI] 1.06-2.41), advanced age (HR 1.07, 95% CI 1.05-1.09), stroke severity (mRS 3-5 vs 1-2; HR 2.02, 95% CI 1.58-2.58), smoking (HR 1.44, 95% CI 1.10-1.88), and cardiac failure (HR 1.53, 95% CI 1.14-2.06). SVD was associated with cardiac cause of death (p = 0.021). CONCLUSIONS: In this well-characterized ischemic stroke cohort of patients aged 55-85 years with a 12-year follow-up, acute index stroke attributable to SVD was associated with poorer long-term survival and higher risk for cardiac death than other stroke subtypes.
Authors: Saloua Akoudad; Mohammad Arfan Ikram; Peter Jan Koudstaal; Albert Hofman; Aad van der Lugt; Meike Willemijn Vernooij Journal: Eur J Epidemiol Date: 2013-09-26 Impact factor: 8.082
Authors: Carole L White; Jeff M Szychowski; Ana Roldan; Marie-France Benavente; Edwin J Pretell; Oscar H Del Brutto; Carlos S Kase; Antonio Arauz; Brett C Meyer; Irene Meissner; Bart M Demaerschalk; Leslie A McClure; Christopher S Coffey; Lesly A Pearce; Robin Conwit; Lisa H Irby; Kalyani Peri; Pablo E Pergola; Robert G Hart; Oscar R Benavente Journal: J Stroke Cerebrovasc Dis Date: 2012-04-17 Impact factor: 2.136
Authors: Young Dae Kim; Kyung Yul Lee; Hyo Suk Nam; Sang Won Han; Jong Yun Lee; Han-Jin Cho; Gyu Sik Kim; Seo Hyun Kim; Myoung-Jin Cha; Seong Hwan Ahn; Seung-Hun Oh; Kee Ook Lee; Yo Han Jung; Hye-Yeon Choi; Sang-Don Han; Hye Sun Lee; Chung Mo Nam; Eun Hye Kim; Ki Jeong Lee; Dongbeom Song; Hui-Nam Park; Ji Hoe Heo Journal: Yonsei Med J Date: 2015-03 Impact factor: 2.759
Authors: Niku Oksala; Marianne Jaroma; Juha-Pekka Pienimäki; Tommi Kuorilehto; Teemu Vänttinen; Antti Lehtomäki; Veli-Pekka Suominen; Prasun Dastidar; Kimmo Mäkinen; Timo Erkinjuntti; Juha-Pekka Salenius Journal: Cerebrovasc Dis Extra Date: 2014-06-07