Kohei Suzuyama1, Yusuke Yakushiji1, Atsushi Ogata2, Masashi Nishihara3, Makoto Eriguchi1, Atsushi Kawaguchi4, Tomoyuki Noguchi5, Junko Nakajima6, Hideo Hara1. 1. Division of Neurology, Department of Internal Medicine, 476002Saga University Faculty of Medicine, Saga, Japan. 2. Department of Neurosurgery, 476002Saga University Faculty of Medicine, Saga, Japan. 3. Department of Radiology, 476002Saga University Faculty of Medicine, Saga, Japan. 4. Education and Research Center for Community Medicine, 476002Saga University Faculty of Medicine, Saga, Japan. 5. Department of Radiology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan. 6. Department of Radiology, Yuai-Kai Oda Hospital, Kashima, Japan.
Abstract
BACKGROUND AND AIMS: We explored the association between the total small vessel disease score obtained from baseline magnetic resonance imaging and subsequent cerebro-cardiovascular events in neurologically healthy Japanese adults. METHODS: The presence of small vessel disease features, including lacunae, cerebral microbleeds, white matter changes, and basal ganglia perivascular spaces on magnetic resonance imaging, was summed to obtain a "total small vessel disease score" (range, 0-4). After excluding participants with previous stroke or ischemic heart disease, intracranial artery stenosis (≥50%), or cerebral aneurysm (≥4 mm), a total of 1349 participants (mean age, 57.7 years; range, 22.8-85.0 years; 46.9% male) were classified into three groups by total small vessel disease score: 0 (n = 984), 1 (n = 269), and ≥2 (n = 96). Cerebro-cardiovascular events (i.e., any stroke, transient ischemic attack, ischemic heart disease, acute heart failure, and aortic dissection) were defined as the primary end point. The hazard ratio (HR) of events during follow-up was calculated using Cox proportional hazards modeling with adjustments for age, sex, hypertension, diabetes mellitus, and smoking. Cumulative event-free rates were estimated using the Kaplan-Meier method. RESULTS: During follow-up (mean, 6.7 years), 35 cerebro-cardiovascular (16 cerebrovascular) events were identified. Higher small vessel disease score was associated with increased risk of cerebro-cardiovascular events (HR per unit increase, 2.17; 95% confidence interval, 1.36-3.46; P = 0.001). Events were more frequent among participants with higher score (P < 0.001, log-rank test). CONCLUSIONS: This study offered additional evidence for the clinical relevance of total small vessel disease score, suggesting the score as a promising tool to predict the risk of subsequent vascular events even in healthy populations.
BACKGROUND AND AIMS: We explored the association between the total small vessel disease score obtained from baseline magnetic resonance imaging and subsequent cerebro-cardiovascular events in neurologically healthy Japanese adults. METHODS: The presence of small vessel disease features, including lacunae, cerebral microbleeds, white matter changes, and basal ganglia perivascular spaces on magnetic resonance imaging, was summed to obtain a "total small vessel disease score" (range, 0-4). After excluding participants with previous stroke or ischemic heart disease, intracranial artery stenosis (≥50%), or cerebral aneurysm (≥4 mm), a total of 1349 participants (mean age, 57.7 years; range, 22.8-85.0 years; 46.9% male) were classified into three groups by total small vessel disease score: 0 (n = 984), 1 (n = 269), and ≥2 (n = 96). Cerebro-cardiovascular events (i.e., any stroke, transient ischemic attack, ischemic heart disease, acute heart failure, and aortic dissection) were defined as the primary end point. The hazard ratio (HR) of events during follow-up was calculated using Cox proportional hazards modeling with adjustments for age, sex, hypertension, diabetes mellitus, and smoking. Cumulative event-free rates were estimated using the Kaplan-Meier method. RESULTS: During follow-up (mean, 6.7 years), 35 cerebro-cardiovascular (16 cerebrovascular) events were identified. Higher small vessel disease score was associated with increased risk of cerebro-cardiovascular events (HR per unit increase, 2.17; 95% confidence interval, 1.36-3.46; P = 0.001). Events were more frequent among participants with higher score (P < 0.001, log-rank test). CONCLUSIONS: This study offered additional evidence for the clinical relevance of total small vessel disease score, suggesting the score as a promising tool to predict the risk of subsequent vascular events even in healthy populations.
Entities:
Keywords:
Cerebral small vessel disease; coronary heart disease; hypertension; magnetic resonance imaging; stroke; vascular event
Authors: Victor J Del Brutto; Robertino Mera; Bettsy Y Recalde; Denisse A Rumbea; Aldo F Costa; Oscar H Del Brutto Journal: Eur Stroke J Date: 2021-11-10