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Total Cerebral Small-Vessel Disease Score is Associated with Mortality during Follow-Up after Acute Ischemic Stroke

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Author(s)
Tae-Jin SongJinkwon KimDongbeom SongJoonsang YooHye Sun LeeYong-Jae KimHyo Suk NamJi Hoe HeoYoung Dae Kim
Keimyung Author(s)
Yoo, Joon Sang
Department
Dept. of Neurology (신경과학)
Journal Title
Journal of Clinical Neurology
Issued Date
2017
Volume
13
Issue
2
Keyword
cerebral small-vessel diseasescerebral microbleedswhite-matter hyperintensitiesperivascular spacesasymptomatic lacunar infarctions
Abstract
Background and Purpose :The recently developed total cerebral small-vessel disease (CSVD) score might appropriately reflect the total burden or severity of CSVD. We investigated whether the total CSVD score is associated with long-term outcomes during follow-up in patients with acute ischemic stroke.
Methods: In total, 1,096 consecutive patients with acute ischemic stroke who underwent brain magnetic resonance imaging were enrolled. We calculated the total CSVD score for each patient after determining the burden of cerebral microbleeds (CMBs), high-grade white-matter hyperintensities (HWHs), high-grade perivascular spaces (HPVSs), and asymptomatic lacunar infarctions (ALIs). We recorded the date and cause of death for all of the patients using data from the Korean National Statistical Office. We compared the long-term mortality rate with the total CSVD score using Cox proportional-hazards models.
Results: CMBs were found in 26.8% of the subjects (294/1,096), HWHs in 16.4% (180/1,096), HPVSs in 19.3% (211/1,096), and ALIs in 38.0% (416/1,096). After adjusting for age, sex, and variables that were significant at p<0.1 in the univariate analysis, the total CSVD score was independently associated with long-term death from all causes [hazard ratio (HR)=1.18 per point, 95% confidence interval (CI)=1.07–1.30], ischemic stroke (HR=1.20 per point, 95% CI=1.01–1.42), and hemorrhagic stroke (HR=2.05 per point, 95% CI=1.30–3.22), but not with fatal cardiovascular events (HR=1.17 per point, 95% CI=0.82–1.67).
Conclusions :The total CSVD score is a potential imaging biomarker for predicting mortality during follow-up in patients with acute ischemic stroke.
Keimyung Author(s)(Kor)
유준상
Publisher
School of Medicine
Citation
Tae-Jin Song et al. (2017). Total Cerebral Small-Vessel Disease Score is Associated with Mortality during Follow-Up after Acute Ischemic Stroke. Journal of Clinical Neurology, 13(2), 187–195. doi: 10.3988/jcn.2017.13.2.187
Type
Article
ISSN
1738-6586
DOI
10.3988/jcn.2017.13.2.187
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32449
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
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