Prior intracerebral hemorrhage and white matter hyperintensity burden on recurrent stroke risk

Abstract Prior intracerebral hemorrhage (ICH) is associated with increased risk of ischemic stroke. Since white matter hyperintensity (WMH) is associated with ischemic stroke and ICH, this study aimed to evaluate the relationship between ICH and the risk of recurrent stroke by WMH severity. From a p...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Jong-Ho Park, Sun U. Kwon, Hyuk Sung Kwon, Sung Hyuk Heo
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f80ecd80778149efaf20e95acbeb0661
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:f80ecd80778149efaf20e95acbeb0661
record_format	dspace
spelling	oai:doaj.org-article:f80ecd80778149efaf20e95acbeb06612021-12-02T19:04:01ZPrior intracerebral hemorrhage and white matter hyperintensity burden on recurrent stroke risk10.1038/s41598-021-96809-32045-2322https://doaj.org/article/f80ecd80778149efaf20e95acbeb06612021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-96809-3https://doaj.org/toc/2045-2322Abstract Prior intracerebral hemorrhage (ICH) is associated with increased risk of ischemic stroke. Since white matter hyperintensity (WMH) is associated with ischemic stroke and ICH, this study aimed to evaluate the relationship between ICH and the risk of recurrent stroke by WMH severity. From a prospective multicenter database comprising 1454 noncardioembolic stroke patients with cerebral small-vessel disease, patients were categorized by presence or absence of prior ICH and WMH severity: mild-moderate WMH (reference); advanced WMH; ICH with mild-moderate WMH; and ICH with advanced WMH. Among patients with ICH, the association with stroke outcomes by WMH burden was further assessed. The primary endpoint was ischemic stroke and hemorrhagic stroke. The secondary endpoint was major adverse cardiovascular events (MACE): stroke/coronary heart disease/vascular death. During the mean 1.9-year follow-up period, the ischemic stroke incidence rate per 100 person-years was 2.7, 4.0, 2.5, and 8.1 in increasing severity, and the rate of hemorrhagic stroke was 0.7, 1.3, 0.6, and 2.1, respectively. The risk of ischemic stroke was higher in ICH with advanced WMH (adjusted HR 2.62; 95% CI 1.22−5.60) than the reference group, while the risk of hemorrhagic stroke trended higher (3.75, 0.85–16.53). The risk of MACE showed a similar pattern in ICH with advanced WMH. Among ICH patients, compared with mild WMH, the risk of ischemic stroke trended to be higher in advanced WMH (HR 3.37; 95% CI 0.90‒12.61). Advanced WMH was independently associated with an increased risk of hemorrhagic stroke (HR 33.96; 95% CI 1.52−760.95). Given the fewer rate of hemorrhagic stroke, the risk of hemorrhagic stroke might not outweigh the benefits of antiplatelet therapy for secondary prevention.Jong-Ho ParkSun U. KwonHyuk Sung KwonSung Hyuk HeoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jong-Ho Park Sun U. Kwon Hyuk Sung Kwon Sung Hyuk Heo Prior intracerebral hemorrhage and white matter hyperintensity burden on recurrent stroke risk
description	Abstract Prior intracerebral hemorrhage (ICH) is associated with increased risk of ischemic stroke. Since white matter hyperintensity (WMH) is associated with ischemic stroke and ICH, this study aimed to evaluate the relationship between ICH and the risk of recurrent stroke by WMH severity. From a prospective multicenter database comprising 1454 noncardioembolic stroke patients with cerebral small-vessel disease, patients were categorized by presence or absence of prior ICH and WMH severity: mild-moderate WMH (reference); advanced WMH; ICH with mild-moderate WMH; and ICH with advanced WMH. Among patients with ICH, the association with stroke outcomes by WMH burden was further assessed. The primary endpoint was ischemic stroke and hemorrhagic stroke. The secondary endpoint was major adverse cardiovascular events (MACE): stroke/coronary heart disease/vascular death. During the mean 1.9-year follow-up period, the ischemic stroke incidence rate per 100 person-years was 2.7, 4.0, 2.5, and 8.1 in increasing severity, and the rate of hemorrhagic stroke was 0.7, 1.3, 0.6, and 2.1, respectively. The risk of ischemic stroke was higher in ICH with advanced WMH (adjusted HR 2.62; 95% CI 1.22−5.60) than the reference group, while the risk of hemorrhagic stroke trended higher (3.75, 0.85–16.53). The risk of MACE showed a similar pattern in ICH with advanced WMH. Among ICH patients, compared with mild WMH, the risk of ischemic stroke trended to be higher in advanced WMH (HR 3.37; 95% CI 0.90‒12.61). Advanced WMH was independently associated with an increased risk of hemorrhagic stroke (HR 33.96; 95% CI 1.52−760.95). Given the fewer rate of hemorrhagic stroke, the risk of hemorrhagic stroke might not outweigh the benefits of antiplatelet therapy for secondary prevention.
format	article
author	Jong-Ho Park Sun U. Kwon Hyuk Sung Kwon Sung Hyuk Heo
author_facet	Jong-Ho Park Sun U. Kwon Hyuk Sung Kwon Sung Hyuk Heo
author_sort	Jong-Ho Park
title	Prior intracerebral hemorrhage and white matter hyperintensity burden on recurrent stroke risk
title_short	Prior intracerebral hemorrhage and white matter hyperintensity burden on recurrent stroke risk
title_full	Prior intracerebral hemorrhage and white matter hyperintensity burden on recurrent stroke risk
title_fullStr	Prior intracerebral hemorrhage and white matter hyperintensity burden on recurrent stroke risk
title_full_unstemmed	Prior intracerebral hemorrhage and white matter hyperintensity burden on recurrent stroke risk
title_sort	prior intracerebral hemorrhage and white matter hyperintensity burden on recurrent stroke risk
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/f80ecd80778149efaf20e95acbeb0661
work_keys_str_mv	AT jonghopark priorintracerebralhemorrhageandwhitematterhyperintensityburdenonrecurrentstrokerisk AT sunukwon priorintracerebralhemorrhageandwhitematterhyperintensityburdenonrecurrentstrokerisk AT hyuksungkwon priorintracerebralhemorrhageandwhitematterhyperintensityburdenonrecurrentstrokerisk AT sunghyukheo priorintracerebralhemorrhageandwhitematterhyperintensityburdenonrecurrentstrokerisk
_version_	1718377244531884032

Prior intracerebral hemorrhage and white matter hyperintensity burden on recurrent stroke risk

Ejemplares similares