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Precursors of Stroke Incidence and Prognosis

中风发生率和预后的前兆

基本信息

批准号：
10660510
负责人：
Hugo Javier Aparicio
金额：
$ 150.94万
依托单位：
BOSTON UNIVERSITY MEDICAL CAMPUS
依托单位国家：
美国
项目类别：
财政年份：
1981
资助国家：
美国
起止时间：
1981-12-01 至 2028-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10660510
关键词：
Acute Affect Age Alzheimer&apos s Disease Alzheimer&apos s disease related dementia Area Atherosclerosis Risk in Communities Atrial Fibrillation Black Populations Black race Blood Vessels Body mass index Brain imaging Cardiovascular system Categories Central obesity Cerebral small vessel disease Characteristics Clinical Clinical Data Clinical Research Cognitive deficits Cohort Studies Collaborations Communities Complex Data Dementia Development Diabetes Mellitus Disease Drug Targeting Dyslipidemias Education Educational Status Epidemic Epidemiology Exposure to Framingham Heart Study Gene Expression Gene Proteins Genes Genetic Genetic Determinism Genetic Risk Genomics Goals Hypertension Image Impaired cognition Incidence Individual Injury Knowledge Lesion Life Life Cycle Stages Life Style Link Lipids Location Longevity Machine Learning Measures Mendelian randomization Methods Modeling Multiomic Data National Institute of Neurological Disorders and Stroke Neuropsychological Tests Obesity Organ Participant Pathway interactions Pattern Pharmaceutical Preparations Pharmacotherapy Population Predictive Factor Prevalence Prevention Prevention strategy Prevention trial Prognosis Proteomics Public Health Reasons for Geographic And Racial Differences in Stroke Recurrence Research Research Personnel Research Priority Resources Risk Risk Assessment Risk Factors Risk Marker Role Sampling Secondary to Severities Stroke Surveillance Program Survivors Thick Time Treatment Factor Validation Work biracial brain health burden of illness cardiovascular risk factor cerebrovascular clinical practice clinical risk cognitive performance cohort comorbidity dementia risk deprivation disability drug repurposing follow-up gray matter high dimensionality improved indexing lifetime risk machine learning method method development multimodal data neighborhood disadvantage neuroimaging novel personalized intervention polygenic risk score post stroke post stroke cognitive impairment predictive modeling predictive tools prevent primary outcome programs prospective public health intervention racial population resilience risk prediction risk prediction model sex social social determinants social factors social health determinants stroke cognitive outcome stroke incidence stroke risk stroke survivor tool transcriptomics trend vascular cognitive impairment and dementia vascular risk factor

项目摘要

PROJECT SUMMARY/ABSTRACT Post-stroke cognitive impairment and dementia (PS-VCID) are major contributors to Alzheimer’s disease and related dementias (ADRD), occurring in 30% of stroke survivors. An individual’s complex life-course exposure to vascular risk factors, along with the varying prevalence and incidence of cardiovascular risk factors among the U.S. population, make study of the link between life-course exposure to cardiovascular risk factors and ADRD a priority. Furthermore, the ability to accurately estimate an individual’s risk for PS-VCID at a particular timepoint in life, even before a stroke occurs, is critical for planning personalized and public health interventions to improve brain health and resilience. Risk factors such as obesity and dyslipidemia have gained epidemic proportions in the U.S., but their causal role and contribution to PS-VCID risk are undefined. Further, PS-VCID risk prediction tools using multimodal data and in multiple racial groups are not available. This proposal seeks to leverage FHS data and resources to generate an understanding of PS-VCID trends and determinants, to collaborate with REGARDS and ARIC study investigators to develop and validate in bi-racial participants comprehensive PS- VCID risk prediction tools (including incorporation of a measure of social determinant of health), to study the causal relations of obesity and dyslipidemia with PS-VCID, to explore repurposing of available drug treatments, and to inform prevention strategies and treatment targets for PS-VCID. Specific Aims include: Aim 1, to describe trends in PS-VCID risk in community dwelling individuals; Aim 2, to evaluate the life-course correlates of PS- VCID using novel machine learning methods to exame the relation of repeated exposure measures, assessed prospectively over seven decades, with PS-VCID, including i) Framingham Stroke Risk Profile components, ii) lipid fractions, iii) obesity indicators, iv) hypertension types, and v) multi-organ disease; Aim 3, to develop two PS-VCID risk prediction tools (PS-VCID risk scores) for i) clinical risk assessment (based on cardiovascular risk factors, obesity measures, and dyslipidemia) and ii) use in research (with addition of brain imaging-derived factors quantifying global cerebral small vessel disease burden, global gray matter volume and cortical thickness, social factors (Area deprivation index) and genetic factors based on identification of the optimal polygenic risk score for each vascular risk factor). Scores will be developed in the well-characterized FHS and REGARDS cohorts, and then assessed and validated in the ARIC study. Aim 4, to study the causal relation of obesity and dyslipidemia with PS-VCID and explore drug repurposing strategies in an instrumental variable analyses framework.

项目总结/文摘

项目成果

期刊论文数量（108）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Cerebral ischemia with mitral valve prolapse.

脑缺血伴二尖瓣脱垂。

DOI：
10.1016/0002-8703(87)90959-8
发表时间：
1987
期刊：
American heart journal
影响因子：
4.8
作者：
Wolf,PA;Sila,CA
通讯作者：
Sila,CA

Covert Cerebral Small Vessel Disease: Ready for Clinical Prime Time.

隐性脑小血管疾病：为临床黄金时间做好准备。

DOI：
10.1161/jaha.123.029891
发表时间：
2023
期刊：
Journal of the American Heart Association
影响因子：
5.4
作者：
Hannawi,Yousef;Vaishnav,Anand;Coskun,ElifPinar;Gangadhara,Suhas;Romero,JoseRafael
通讯作者：
Romero,JoseRafael

Prevention of strokes.

预防中风。