Proportion of intracerebral haemorrhage due to cerebral amyloid angiopathy in the East and West: Comparison between single hospital centres in Japan and the United Kingdom
Proportion of intracerebral haemorrhage due to cerebral amyloid angiopathy in the East and West: Comparison between single hospital centres in Japan and the United Kingdom
复制标题
DOI：
10.1016/j.jns.2020.117037
复制
发表时间：
2020-09-15
影响因子：
4.4
通讯作者：
Werringa, David J.
中科院分区：
文献类型：
--
作者：
Yakushiji, Yusuke;Tanaka, Jun;Werringa, David J.
目的：我们调查是否脑内出血（ICH）的比例，由于脑淀粉样血管病（CAA）不同的住院患者在East and West.Methods：这一国际横断面研究包括连续自发性ICH患者在英国（西方中心起源）和一个中风中心在日本（东方中心起源）在同一时期。我们使用爱丁堡CT诊断标准将自发性ICH分为“CAA相关”或“其他”。我们使用多变量逻辑回归分析来评估CAA相关ICH与地理位置或种族（白色vs.东亚或其他种族）之间的关系。敏感性分析进行了修改后的波士顿MRI为基础的诊断标准CAA相关的ICH.Results：433例患者（中位年龄，72岁;西方中心的起源，55%），15%被归类为CAA相关的ICH。在多变量logistic回归模型中，东部中心和种族的CAA相关ICH比例较低（比值比[OR] vs.西部中心起源0.55，95%CI 0.31-0.98; OR [vs.白色] 0.47，95%CI 0.25-0.87）;这些结果在敏感性分析中保持稳健。“其他”（非CAA）ICH的估计发生率（归因于高血压动脉病）是2.5倍高，在东亚population.Conclusions：比例CAA相关的ICH是较低的，在东方相比，西方医院ICH人口;这可能是由于东亚人群中与高血压动脉病相关的ICH发病率较高，这表明最佳的ICH预防策略可能在东西方之间有所不同。
Purpose: We investigated whether the proportion of intracerebral haemorrhage (ICH) due to cerebral amyloid angiopathy (CAA) differs between patients admitted to hospitals in the East and the West.Methods: This international cross-sectional study included consecutive spontaneous ICH patients admitted to one stroke centre in the United Kingdom (Western centre origin) and one in Japan (Eastern centre origin) during the same period. We classified spontaneous ICH into "CAA-related" or "other" using the Edinburgh CT-based diagnostic criteria. We used multivariable logistic regression analyses to assess the relationship between CAA-related ICH and geographical location or ethnicity (White vs. East Asian or other ethnicities). Sensitivity analyses were performed using the modified Boston MRI-based diagnostic criteria for CAA-related ICH.Results: Of 433 patients (median age, 72 years; Western centre origin, 55%), 15% were classified as CAA-related ICH. In the multivariable logistic regression model, Eastern centre and ethnicity had a lower proportion of CAA-related ICH (odds ratio [OR] vs Western centre origin 0.55, 95%CI 0.31-0.98; OR [vs. White] 0.47, 95%CI 0.25-0.87); these findings remained robust in sensitivity analyses. The estimated incidence of "other" (non-CAA) ICH (attributed to hypertensive arteriopathy) was 2.5-fold higher in East Asian populations.Conclusions: The proportion CAA-related ICH is lower in an Eastern compared to a Western hospital ICH population; this might be explained by a higher incidence of ICH related to hypertensive arteriopathy in East Asian populations, suggesting that optimal ICH prevention strategies might differ between the East and West.