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

Authors
 Tae-Jin Song  ;  Jinkwon Kim  ;  Dongbeom Song  ;  Joonsang Yoo  ;  Hye Sun Lee  ;  Yong-Jae Kim  ;  Hyo Suk Nam  ;  Ji Hoe Heo  ;  Young Dae Kim 
Citation
 Journal of Clinical Neurology, Vol.13(2) : 187-195, 2017 
Journal Title
 Journal of Clinical Neurology 
ISSN
 1738-6586 
Issue Date
2017
Keywords
asymptomatic lacunar infarctions ; cerebral microbleeds ; cerebral small-vessel diseases ; perivascular spaces ; white-matter hyperintensities
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.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161166
DOI
10.3988/jcn.2017.13.2.187
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원)
Yonsei Authors
김영대(Kim, Young Dae) ; 남효석(Nam, Hyo Suk) ; 송동범(Song, Dong Beom) ; 유준상(Yoo, Joon Sang) ; 이혜선(Lee, Hye Sun) ; 허지회(Heo, Ji Hoe)
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