Microbleeds in the Secondary Prevention of Small Subcortical Strokes Trial: Stroke, mortality, and treatment interactions.
Microbleeds in the Secondary Prevention of Small Subcortical Strokes Trial: Stroke, mortality, and treatment interactions.
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在小型皮层中风试验的二级预防中，微孔虫：中风，死亡率和治疗相互作用。
DOI：
10.1002/ana.24988
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发表时间：
2017-08
影响因子：
11.2
通讯作者：
SPS3 Trial Investigators
中科院分区：
文献类型：
--
作者：
Shoamanesh A;Pearce LA;Bazan C;Catanese L;McClure LA;Sharma M;Marti-Fabregas J;Anderson DC;Kase CS;Hart RG;Benavente OR;SPS3 Trial Investigators
在SPS3试验中描述腔隙性卒中患者的脑微出血（CMBs）特征，并评估其与卒中复发和死亡的关系，以及对指定治疗的反应。SPS3是2003年至2011年间进行的一项随机临床试验。近期mri记录的腔隙性梗死患者被随机分配到收缩压目标水平（SBP; 130 - 149 mmHg vs <130 mmHg；开放标签）和抗血小板治疗（阿司匹林/氯吡格雷vs阿司匹林/安慰剂；双盲）。目前的分析涉及1278名试验参与者，他们具有允许CMB检测的基线轴向T2*- GRE MRI序列。1278例患者（平均年龄63岁）中有30%存在CMBs。男性（OR 1.7, 95%CI 1.3-2.3）、高血压史（1.6,1.2 - 2.3）、收缩压升高（1.2 / 20mmhg, 1.1-1.4）、非糖尿病患者（1.4,1.1-1.9）、多发腔隙性梗死（1.9,1.5-2.5）和MRI上中度（1.7,1.2 - 2.3）或重度（4.2,3.0-5.9）白质高信号与CMBs独立相关。在平均随访3.3年期间，总卒中复发率为每例患者2.5%。CMBs患者卒中复发风险增加2倍（HR 2.1, 1.4-3.1）。CMBs不是死亡的危险因素。CMBs和治疗分配之间没有统计学上显著的相互作用。腔隙性卒中和CMBs患者可能存在更晚期的脑血管疾病，需要有效的治疗策略。
To characterize cerebral microbleeds (CMBs) in lacunar stroke patients in the SPS3 trial and to assess their relationship with recurrent stroke and death, and response to assigned treatment. SPS3 is a randomized, clinical trial conducted between 2003 and 2011. Patients with recent MRI-documented lacunar infarcts were randomly assigned in a factorial design to target levels of systolic blood pressure (SBP; 130–149 mmHg vs <130 mmHg; open-label) and to antiplatelet treatment (aspirin/clopidogrel vs aspirin/placebo; double-blinded). The current analysis involves 1278 trial participants who had a baseline axial T2*- GRE MRI sequence allowing for CMB detection. CMBs were present in 30% of 1278 patients (mean age 63 y). Male gender (OR 1.7, 95%CI 1.3–2.3), history of hypertension (1.6, 1.2–2.3), increased systolic blood pressure (1.2 per 20 mmHg, 1.1–1.4), non-diabetic (1.4, 1.1–1.9), multiple old lacunar infarcts(1.9, 1.5–2.5) and moderate(1.7, 1.2–2.3) or severe (4.2, 3.0–5.9) white matter hyperintensities on MRI were independently associated with CMBs. During a mean follow-up of 3.3 y, overall stroke recurrence was 2.5% per patient-y. Patients with CMBs had an adjusted two-fold increased risk of recurrent stroke (HR 2.1, 1.4–3.1). CMBs were not a risk factor for death. There were no statistically significant interactions between CMBs and treatment assignments. Patients with lacunar stroke and CMBs likely harbor a more advanced form of cerebral small vessel disease in need of efficacious therapeutic strategies.
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DOI：
10.1111/j.1747-4949.2012.00869.x
发表时间：
2013-07
期刊：
International journal of stroke : official journal of the International Stroke Society
影响因子：
--
作者：
Shoamanesh A;Kwok CS;Lim PA;Benavente OR
通讯作者：
Benavente OR
DOI：
10.1056/nejmoa1204133
发表时间：
2012-08-30
期刊：
The New England journal of medicine
影响因子：
--
作者：
SPS3 Investigators;Benavente OR;Hart RG;McClure LA;Szychowski JM;Coffey CS;Pearce LA
通讯作者：
Pearce LA
影响因子：
48
作者：
Greenberg, Steven M.;Vernooij, Meike W.;Cordonnier, Charlotte;Viswanathan, Anand;Salman, Rustorn Al-Shahi;Warach, Steven;Launer, Lenore J.;Van Buchem, Mark A.;Breteler, Monique M. B.
通讯作者：
Breteler, Monique M. B.
影响因子：
6.7
作者：
Mok, Vincent C. T.;Lau, Alexander Y. L.;Wong, Lawrence K. S.
通讯作者：
Wong, Lawrence K. S.
影响因子：
12.7
作者：
Schrag M;McAuley G;Pomakian J;Jiffry A;Tung S;Mueller C;Vinters HV;Haacke EM;Holshouser B;Kido D;Kirsch WM
通讯作者：
Kirsch WM