Michal Rozanski1, Tobias B Richter, Ulrike Grittner, Matthias Endres, Jochen B Fiebach, Gerhard J Jungehulsing. 1. From the Center for Stroke Research Berlin (M.R., T.B.R., U.G., M.E., J.B.F., G.J.J.), Department of Neurology (M.R., M.E.), ExcellenceCluster NeuroCure (M.E.), German Center for Neurodegenerative Diseases (M.E.), and German Center for Cardiovascular Research (M.E.), and Department for Biostatistics and Clinical Epidemiology (U.G.), Charité-Universitätsmedizin, Berlin; and Department of Neurology, The Jewish Hospital, Berlin (G.J.J.).
Abstract
BACKGROUND AND PURPOSE: This study was conducted to investigate the association of cerebral white matter disease (WMD) on MRI with vascular risk factors and laboratory findings in consecutive first acute ischemic stroke patients. METHODS: Acute ischemic stroke patients underwent MRI ≤24 hours after stroke onset and follow-up on day 2. WMD was scored on fluid attenuated inversion recovery MRI according to the Wahlund score. Vascular risk factors and laboratory parameters were assessed during hospital stay. Univariate and multiple logistic regression analyses were performed. RESULTS: We included 512 patients with first acute ischemic stroke (mean age, 68.5 [SD, 13.2] years; 192 women (37.5%); median National Institutes of Health Stroke Scale on admission, 3 [interquartile range, 1-6]; and median Wahlund score, 4 [interquartile range, 2-9]). WMD was present in 460 (89.8%) patients. In univariate analysis, age, arterial hypertension, reduced estimated glomerular filtration rate, hemoglobin A1c (HbA1c) levels, diabetes mellitus, and female sex were associated with the presence of WMD (P<0.05). In multiple regression analysis, age, arterial hypertension, and elevated levels of HbA1c (P<0.05) remained independently associated with the extent of WMD. CONCLUSIONS: Among known risk factors, higher levels of HbA1c were associated with cerebral WMD in stroke patients. This may suggest that chronic disturbance of glycemia measured by HbA1c plays a role in the pathophysiology of WMD. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00715533.
BACKGROUND AND PURPOSE: This study was conducted to investigate the association of cerebral white matter disease (WMD) on MRI with vascular risk factors and laboratory findings in consecutive first acute ischemic strokepatients. METHODS: Acute ischemic strokepatients underwent MRI ≤24 hours after stroke onset and follow-up on day 2. WMD was scored on fluid attenuated inversion recovery MRI according to the Wahlund score. Vascular risk factors and laboratory parameters were assessed during hospital stay. Univariate and multiple logistic regression analyses were performed. RESULTS: We included 512 patients with first acute ischemic stroke (mean age, 68.5 [SD, 13.2] years; 192 women (37.5%); median National Institutes of Health Stroke Scale on admission, 3 [interquartile range, 1-6]; and median Wahlund score, 4 [interquartile range, 2-9]). WMD was present in 460 (89.8%) patients. In univariate analysis, age, arterial hypertension, reduced estimated glomerular filtration rate, hemoglobin A1c (HbA1c) levels, diabetes mellitus, and female sex were associated with the presence of WMD (P<0.05). In multiple regression analysis, age, arterial hypertension, and elevated levels of HbA1c (P<0.05) remained independently associated with the extent of WMD. CONCLUSIONS: Among known risk factors, higher levels of HbA1c were associated with cerebral WMD in strokepatients. This may suggest that chronic disturbance of glycemia measured by HbA1c plays a role in the pathophysiology of WMD. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00715533.
Entities:
Keywords:
ischemia; leukoencephalopathies; magnetic resonance imaging
Authors: Regina von Rennenberg; Bob Siegerink; Ramanan Ganeshan; Kersten Villringer; Wolfram Doehner; Heinrich J Audebert; Matthias Endres; Christian H Nolte; Jan F Scheitz Journal: J Neurol Date: 2018-10-11 Impact factor: 4.849