Total Cerebral Small-Vessel Disease Score is Associated with Mortality during Follow-Up after Acute Ischemic Stroke.
Total Cerebral Small-Vessel Disease Score is Associated with Mortality during Follow-Up after Acute Ischemic Stroke.
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DOI：
10.3988/jcn.2017.13.2.187
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发表时间：
2017-04
期刊：
影响因子：
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通讯作者：
Kim YD
中科院分区：
文献类型：
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作者：
Song TJ;Kim J;Song D;Yoo J;Lee HS;Kim YJ;Nam HS;Heo JH;Kim YD
最近开发的总脑小血管疾病（CSVD）评分可能适当地反映CSVD的总负担或严重程度。我们研究了CSVD总评分是否与急性缺血性卒中患者随访期间的长期结局相关。总共招募了1,096例接受脑磁共振成像的急性缺血性卒中患者。在确定脑微出血（CMB）、高级别白质高信号（HWHs）、高级别血管周围间隙（HPVSs）和无症状腔隙性梗死（ALI）的负担后，我们计算了每例患者的CSVD总分。我们使用韩国国家统计局的数据记录了所有患者的死亡日期和原因。我们使用考克斯比例风险模型比较了长期死亡率和CSVD总评分。26.8%的受试者（294/1，096）发现CMB，16.4%（180/1，096）发现HWH，19.3%（211/1，096）发现HPVS，38.0%（416/1，096）发现ALI。在调整了年龄、性别和单变量分析中p<0.1的变量后，CSVD总评分与所有原因引起的长期死亡独立相关[风险比（HR）=1.18/点，95%置信区间（CI）=1.07-1.30]，缺血性卒中（HR=1.20/点，95% CI=1.01-1.42）和出血性卒中（HR=2.05/点，95% CI=1.30-3.22），但未发生致死性心血管事件（HR=1.17/点，95% CI=0.82-1.67）。CSVD总评分是预测急性缺血性卒中患者随访期间死亡率的潜在影像学生物标志物。
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. 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. 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). The total CSVD score is a potential imaging biomarker for predicting mortality during follow-up in patients with acute ischemic stroke.