Ayeesha Kamran Kamal1, Farzin Majeed2, Omrana Pasha3, Muhammad Islam4, Iqbal Azam4, Muhammad Saleem Ilyas5, Munawar Hussain6, Kamran Masood7, Bilal Ahmed8, Sumaira Nazir9, Zafar Sajjad10, Scott E Kasner11. 1. Associate Professor Neurology, Stroke Service, The International Cerebrovascular Translational Clinical Research Training Program (Fogarty International Center, National Institutes of Health) and Aga Khan University, Karachi, Pakistan ; Joint First Authors ; Corresponding Author. 2. Fogarty Cerebrovascular Research Fellow, The International Cerebrovascular Translational Clinical Research Training Program (Fogarty International Center, National Institutes of Health) and Aga Khan University, Karachi, Pakistan ; Joint First Authors. 3. Associate Professor, Director Masters in Epidemiology and Biostatistics Program, Community Health Sciences, Aga Khan University Karachi, Pakistan. 4. Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan. 5. Professor of Neurology, Dow University of Health Sciences, Karachi, Pakistan. 6. Associate Professor and Head, Dow Institute of Radiology, Dow University of Health Sciences, Karachi, Pakistan. 7. Radiology Resident, Dow Institute of Radiology, Dow University of Health Sciences, Karachi, Pakistan. 8. Epidemiology and Biostatistics, Dept. of Medicine, Aga Khan University, Karachi, Pakistan. 9. Research Associate, The International Cerebrovascular Translational Clinical Research Training Program (Fogarty International Center, National Institutes of Health) and Aga Khan University, Karachi, Pakistan. 10. Associate Professor and Head, Radiology, Aga Khan University, Karachi, Pakistan. 11. Professor of Neurology, Chief of the Division of Stroke and Neurointensive Care, and Director of the Comprehensive Stroke Center University of Pennsylvania, USA.
Abstract
BACKGROUND: Intracranial atherosclerotic disease (ICAD) is the most frequent subtype of ischemic stroke globally. It is important to describe the determinants of early ICAD as a strategy to prevent strokes from clinically evident and progressive ICAD. Our objective is to report the determinants of asymptomatic ICAD by linking the presence or absence of ICAD on magnetic resonance angiogram (MRA) with detailed risk assessment in asymptomatic adults. METHODS: This is an observational cross-sectional analytical study. We plan to recruit 200 adult participants from the radiology departments of two tertiary care centers of Karachi, Pakistan. The participants will first be screened for the absence of stroke symptoms via the Questionnaire for Verifying Stroke Free Status (QVSFS). QVSFS negative will be participants will be eligible. After written informed consent, participants will undergo detailed medical, sociodemographic, lifestyle, and anthropometric evaluation by a detailed interview. They will, in addition, undergo MRA to study the presence, degree, and distribution of asymptomatic ICAD. All MRA scans will be reviewed centrally by vascular neurologists blinded to clinical information. These images would be reviewed on DICOM Viewer 3.0 used for calculating the degree of stenosis using Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) study defined criteria employing electronic calipers. A sample size of 200 will achieve 80% power for detecting a minimum difference of 20% in the prevalence of exposure factors (medical and lifestyle) between asymptomatic ICAD positive and ICAD negative persons. This study will generate regional data on risks for ICAD development and prevention in a high-risk susceptible population. Study ID: NCT02072876.
BACKGROUND:Intracranial atherosclerotic disease (ICAD) is the most frequent subtype of ischemic stroke globally. It is important to describe the determinants of early ICAD as a strategy to prevent strokes from clinically evident and progressive ICAD. Our objective is to report the determinants of asymptomatic ICAD by linking the presence or absence of ICAD on magnetic resonance angiogram (MRA) with detailed risk assessment in asymptomatic adults. METHODS: This is an observational cross-sectional analytical study. We plan to recruit 200 adult participants from the radiology departments of two tertiary care centers of Karachi, Pakistan. The participants will first be screened for the absence of stroke symptoms via the Questionnaire for Verifying Stroke Free Status (QVSFS). QVSFS negative will be participants will be eligible. After written informed consent, participants will undergo detailed medical, sociodemographic, lifestyle, and anthropometric evaluation by a detailed interview. They will, in addition, undergo MRA to study the presence, degree, and distribution of asymptomatic ICAD. All MRA scans will be reviewed centrally by vascular neurologists blinded to clinical information. These images would be reviewed on DICOM Viewer 3.0 used for calculating the degree of stenosis using Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) study defined criteria employing electronic calipers. A sample size of 200 will achieve 80% power for detecting a minimum difference of 20% in the prevalence of exposure factors (medical and lifestyle) between asymptomatic ICAD positive and ICAD negative persons. This study will generate regional data on risks for ICAD development and prevention in a high-risk susceptible population. Study ID: NCT02072876.
Authors: Maria Khan; Asif Rasheed; Saman Hashmi; Moazzam Zaidi; Muhammad Murtaza; Saba Akhtar; Lajpat Bansari; Nabi Shah; Maria Samuel; Sadaf Raza; Umer Rais Khan; Bilal Ahmed; Bilawal Ahmed; Naveeduddin Ahmed; Jamal Ara; Tasnim Ahsan; S M Munir; Shoukat Ali; Khalid Mehmood; Karim Ullah Makki; Muhammad Masroor Ahmed; Niaz Sheikh; Abdul Rauf Memon; Philippe M Frossard; Ayeesha Kamran Kamal Journal: Int J Stroke Date: 2012-09-27 Impact factor: 5.266
Authors: Hai Wei Huang; Ming Hui Guo; Rui Jin Lin; Ya Li Chen; Qin Luo; Ying Zhang; Ka Sing Wong Journal: Cerebrovasc Dis Date: 2007-05-23 Impact factor: 2.762