schliessen

Filtern

 

Bibliotheken

Cerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies

textabstractBackground: Cerebral microbleeds are a neuroimaging biomarker of stroke risk. A crucial clinical question is whether cerebral microbleeds indicate patients with recent ischaemic stroke or transient ischaemic attack in whom the rate of future intracranial haemorrhage is likely to exceed t... Full description

Journal Title: The Lancet Neurology 2019, Vol.18(7), pp.653-665
Main Author: Wilson, D.
Other Authors: Ambler, G. , Lee, K.-J. , Lim, J.-S. , Shiozawa, M. , Koga, M. , Li, L. , Lovelock, C. , Chabriat, H. , Hennerici, Michael , Wong, Y.K. , Mak, H.K.F. , Prats-Sánchez, L. , Martínez-Domeño, A. , Inamura, S. , Yoshifuji, K. , Arsava, E.M. , Horstmann, Solveig , Purrucker, J. , Lam, B.Y.K. , Wong, A. , Kim, Y.D. , Song, T.-J. , Schrooten, M. , Lemmens, R. , Eppinger, S. , Gattringer, T. , Uysal, E. , Tanriverdi, Z. , Bornstein, Stefan , Assayag, E.B. , Hallevi, H. , Tanaka, J. , Hara, H. , Coutts, S.B. , Hert, L. , Polymeris, A. , Seiffge, D.J. , Lyrer, Philippe , Algra, Ale , Kappelle, Jaap , Al-Shahi Salman, Rustam , Jäger, Rolf , Lip, G.Y.H. , Mattle, H. , Panos, L.D. , Mas, J. , Legrand, L. , Karayiannis, C. , Phan, Thanh , Gunkel, S. , Christ, N. , Abrigo, J. , Leung, T. , Chu, W. , Chappell, F. , Makin, S. , Hayden, D. , Williams, D.J. , Kooi, M. Eline , van Dam-Nolen, D.H.K. , Barbato, C. , Browning, S. , Wiegertjes, K. , Tuladhar, Anil M. , Maaijwee, N. , Guevarra, C. , Yatawara, C. , Mendyk, A.-M. , Delmaire, C. , Köhler, S. , Oostenbrugge, Robert , Zhou, Y. , Xu, C. , Hilal, Saima , Gyanwali, B. , Chen, Christopher , Lou, M. , Staals, Julie , Bordet, R. , Kandiah, N. , Leeuw, Frank , Simister, R. , Lugt, Aad , Kelly, P.J. , Wardlaw, J. , Soo, Y. , Fluri, F. , Srikanth, Velandai , Calvet, D. , Jung, S. , Kwa, V.I.H. , Engelter, Stefan , Peters, N. , Smith, Eric , Yakushiji, Y. , Orken, D.N. , Fazekas, Franz , Thijs, Vincent , Heo, J.H. , Mok, V. , Veltkamp, Roland , Ay, H. , Imaizumi, Toshio , Gomez-Anson, B. , Lau, K.K. , Jouvent, E. , Rothwell, Peter , Toyoda, K. , Bae, H.-J. , Marti-Fabregas, J. , Werring, David , Harkness, K. , Shaw, L. , Sword, J. , Mohd Nor, A. , Sharma, P. , Kelly, D. , Harrington, F. , Randall, M. , Smith, M. , Mahawish, K. , Elmarim, A. , Esisi, B. , Cullen, C. , Nallasivam, A. , Price, C. , Barry, A. , Roffe, C. , Coyle, J. , Hassan, A. , Birns, J. , Cohen, D. , Sekaran, L. , Parry-Jones, A. , Parry, A. , Hargroves, D. , Proschel, H. , Datta, P. , Darawil, K. , Manoj, A. , Burn, M. , Patterson, C. , Giallombardo, E. , Smyth, N. , Mansoor, S. , Anwar, I. , Marsh, R. , Ispoglou, S. , Chadha, D. , Prabhakaran, M. , Meenakishundaram, S. , O'Connell, J. , Scott, J. , Krishnamurthy, V. , Aghoram, P. , McCormick, M. , Sprigg, N. , O'Mahony, P. , Cooper, M. , Choy, L. , Wilkinson, P. , Leach, S. , Caine, S. , Burger, I. , Gunathilagan, G. , Guyler, P. , Emsley, H. , Davis, M. , Manawadu, D. , Pasco, K. , Mamun, M. , Luder, R. , Sajid, M. , Okwera, J. , Warburton, E. , Saastamoinen, K. , England, T. , Putterill, J. , Flossman, E. , Power, M. , Dani, K. , Mangion, D. , Suman, A. , Corrigan, J. , Lawrence, E. , Vahidassr, D. , Shakeshaft, C. , Brown, M. , Charidimou, Andreas , Cohen, H. , Banerjee, G. , Houlden, Henry , White, M. , Yousry, T. , Flossmann, E. , Muir, K. , El-Koussy, M. , Gratz, P. , Molad, J. , Korczyn, A. , Kliper, E. , Maeder, P. , Gass, A. , Pachai, C. , Bracoub, L. , Douste-Blazy, M.-Y. , Fratacci, M.D. , Vicaut, E. , Sato, S. , Miwa, K. , Fujita, K. , Ide, T. , Ma, H. , Ly, J. , Singhal, S. , Chandra, R. , Slater, L.-A. , Soufan, C. , Moran, C. , Traenka, C. , Thilemann, S. , Fladt, J. , Gensicke, Henrik , Bonati, L. , Kim, B.J. , Han, M.-K. , Kang, J. , Ko, E. , Yang, M.H. , Jang, M.S. , Murphy, S. , Carty, F. , Akijian, L. , Thornton, J. , Schembri, M. , Douven, E. , Delgado-Mederos, , R. , Marín, R. , Camps-Renom, P. , Guisado-Alonso, D. , Nuñez, F. , Medrano-Martorell, S. , Merino, E. , Iida, K. , Ikeda, S. , Nishihara, M. , Irie, H. , Demirelli, D.S. , Medanta, J.M.
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: ISSN: ; ISSN: 14744422
Zum Text:
SendSend as email Add to Book BagAdd to Book Bag
Staff View
recordid: narciseur:oai:repub.eur.nl:117259
title: Cerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies
format: Article
creator:
  • Wilson, D.
  • Ambler, G.
  • Lee, K.-J.
  • Lim, J.-S.
  • Shiozawa, M.
  • Koga, M.
  • Li, L.
  • Lovelock, C.
  • Chabriat, H.
  • Hennerici, Michael
  • Wong, Y.K.
  • Mak, H.K.F.
  • Prats-Sánchez, L.
  • Martínez-Domeño, A.
  • Inamura, S.
  • Yoshifuji, K.
  • Arsava, E.M.
  • Horstmann, Solveig
  • Purrucker, J.
  • Lam, B.Y.K.
  • Wong, A.
  • Kim, Y.D.
  • Song, T.-J.
  • Schrooten, M.
  • Lemmens, R.
  • Eppinger, S.
  • Gattringer, T.
  • Uysal, E.
  • Tanriverdi, Z.
  • Bornstein, Stefan
  • Assayag, E.B.
  • Hallevi, H.
  • Tanaka, J.
  • Hara, H.
  • Coutts, S.B.
  • Hert, L.
  • Polymeris, A.
  • Seiffge, D.J.
  • Lyrer, Philippe
  • Algra, Ale
  • Kappelle, Jaap
  • Al-Shahi Salman, Rustam
  • Jäger, Rolf
  • Lip, G.Y.H.
  • Mattle, H.
  • Panos, L.D.
  • Mas, J.
  • Legrand, L.
  • Karayiannis, C.
  • Phan, Thanh
  • Gunkel, S.
  • Christ, N.
  • Abrigo, J.
  • Leung, T.
  • Chu, W.
  • Chappell, F.
  • Makin, S.
  • Hayden, D.
  • Williams, D.J.
  • Kooi, M. Eline
  • van Dam-Nolen, D.H.K.
  • Barbato, C.
  • Browning, S.
  • Wiegertjes, K.
  • Tuladhar, Anil M.
  • Maaijwee, N.
  • Guevarra, C.
  • Yatawara, C.
  • Mendyk, A.-M.
  • Delmaire, C.
  • Köhler, S.
  • Oostenbrugge, Robert
  • Zhou, Y.
  • Xu, C.
  • Hilal, Saima
  • Gyanwali, B.
  • Chen, Christopher
  • Lou, M.
  • Staals, Julie
  • Bordet, R.
  • Kandiah, N.
  • Leeuw, Frank
  • Simister, R.
  • Lugt, Aad
  • Kelly, P.J.
  • Wardlaw, J.
  • Soo, Y.
  • Fluri, F.
  • Srikanth, Velandai
  • Calvet, D.
  • Jung, S.
  • Kwa, V.I.H.
  • Engelter, Stefan
  • Peters, N.
  • Smith, Eric
  • Yakushiji, Y.
  • Orken, D.N.
  • Fazekas, Franz
  • Thijs, Vincent
  • Heo, J.H.
  • Mok, V.
  • Veltkamp, Roland
  • Ay, H.
  • Imaizumi, Toshio
  • Gomez-Anson, B.
  • Lau, K.K.
  • Jouvent, E.
  • Rothwell, Peter
  • Toyoda, K.
  • Bae, H.-J.
  • Marti-Fabregas, J.
  • Werring, David
  • Harkness, K.
  • Shaw, L.
  • Sword, J.
  • Mohd Nor, A.
  • Sharma, P.
  • Kelly, D.
  • Harrington, F.
  • Randall, M.
  • Smith, M.
  • Mahawish, K.
  • Elmarim, A.
  • Esisi, B.
  • Cullen, C.
  • Nallasivam, A.
  • Price, C.
  • Barry, A.
  • Roffe, C.
  • Coyle, J.
  • Hassan, A.
  • Birns, J.
  • Cohen, D.
  • Sekaran, L.
  • Parry-Jones, A.
  • Parry, A.
  • Hargroves, D.
  • Proschel, H.
  • Datta, P.
  • Darawil, K.
  • Manoj, A.
  • Burn, M.
  • Patterson, C.
  • Giallombardo, E.
  • Smyth, N.
  • Mansoor, S.
  • Anwar, I.
  • Marsh, R.
  • Ispoglou, S.
  • Chadha, D.
  • Prabhakaran, M.
  • Meenakishundaram, S.
  • O'Connell, J.
  • Scott, J.
  • Krishnamurthy, V.
  • Aghoram, P.
  • McCormick, M.
  • Sprigg, N.
  • O'Mahony, P.
  • Cooper, M.
  • Choy, L.
  • Wilkinson, P.
  • Leach, S.
  • Caine, S.
  • Burger, I.
  • Gunathilagan, G.
  • Guyler, P.
  • Emsley, H.
  • Davis, M.
  • Manawadu, D.
  • Pasco, K.
  • Mamun, M.
  • Luder, R.
  • Sajid, M.
  • Okwera, J.
  • Warburton, E.
  • Saastamoinen, K.
  • England, T.
  • Putterill, J.
  • Flossman, E.
  • Power, M.
  • Dani, K.
  • Mangion, D.
  • Suman, A.
  • Corrigan, J.
  • Lawrence, E.
  • Vahidassr, D.
  • Shakeshaft, C.
  • Brown, M.
  • Charidimou, Andreas
  • Cohen, H.
  • Banerjee, G.
  • Houlden, Henry
  • White, M.
  • Yousry, T.
  • Flossmann, E.
  • Muir, K.
  • El-Koussy, M.
  • Gratz, P.
  • Molad, J.
  • Korczyn, A.
  • Kliper, E.
  • Maeder, P.
  • Gass, A.
  • Pachai, C.
  • Bracoub, L.
  • Douste-Blazy, M.-Y.
  • Fratacci, M.D.
  • Vicaut, E.
  • Sato, S.
  • Miwa, K.
  • Fujita, K.
  • Ide, T.
  • Ma, H.
  • Ly, J.
  • Singhal, S.
  • Chandra, R.
  • Slater, L.-A.
  • Soufan, C.
  • Moran, C.
  • Traenka, C.
  • Thilemann, S.
  • Fladt, J.
  • Gensicke, Henrik
  • Bonati, L.
  • Kim, B.J.
  • Han, M.-K.
  • Kang, J.
  • Ko, E.
  • Yang, M.H.
  • Jang, M.S.
  • Murphy, S.
  • Carty, F.
  • Akijian, L.
  • Thornton, J.
  • Schembri, M.
  • Douven, E.
  • Delgado-Mederos
  • , R.
  • Marín, R.
  • Camps-Renom, P.
  • Guisado-Alonso, D.
  • Nuñez, F.
  • Medrano-Martorell, S.
  • Merino, E.
  • Iida, K.
  • Ikeda, S.
  • Nishihara, M.
  • Irie, H.
  • Demirelli, D.S.
  • Medanta, J.M.
subjects:
  • Stroke – Risk Factors
  • Ischemia – Risk Factors
ispartof: The Lancet Neurology, 2019, Vol.18(7), pp.653-665
description: textabstractBackground: Cerebral microbleeds are a neuroimaging biomarker of stroke risk. A crucial clinical question is whether cerebral microbleeds indicate patients with recent ischaemic stroke or transient ischaemic attack in whom the rate of future intracranial haemorrhage is likely to exceed that of recurrent ischaemic stroke when treated with antithrombotic drugs. We therefore aimed to establish whether a large burden of cerebral microbleeds or particular anatomical patterns of cerebral microbleeds can identify ischaemic stroke or transient ischaemic attack patients at higher absolute risk of intracranial haemorrhage than ischaemic stroke. Methods: We did a pooled analysis of individual patient data from cohort studies in adults with recent ischaemic stroke or transient ischaemic attack. Cohorts were eligible for inclusion if they prospectively recruited adult participants with ischaemic stroke or transient ischaemic attack; included at least 50 participants; collected data on stroke events over at least 3 months follow-up; used an appropriate MRI sequence that is sensitive to magnetic susceptibility; and documented the number and anatomical distribution of cerebral microbleeds reliably using consensus criteria and validated scales. Our prespecified primary outcomes were a composite of any symptomatic intracranial haemorrhage or ischaemic stroke, symptomatic intracranial haemorrhage, and symptomatic ischaemic stroke. We registered this study with the PROSPERO international prospective register of systematic reviews, number CRD42016036602. Findings: Between Jan 1, 1996, and Dec 1, 2018, we identified 344 studies. After exclusions for ineligibility or declined requests for inclusion, 20 322 patients from 38 cohorts (over 35 225 patient-years of follow-up; median 1·34 years [IQR 0·19–2·44]) were included in our analyses. The adjusted hazard ratio [aHR] comparing patients with cerebral microbleeds to those without was 1·35 (95% CI 1·20–1·50) for the composite outcome of intracranial haemorrhage and ischaemic stroke; 2·45 (1·82–3·29) for intracranial haemorrhage and 1·23 (1·08–1·40) for ischaemic stroke. The aHR increased with increasing cerebral microbleed burden for intracranial haemorrhage but this effect was less marked for ischaemic stroke (for five or more cerebral microbleeds, aHR 4·55 [95% CI 3·08–6·72] for intracranial haemorrhage vs 1·47 [1·19–1·80] for ischaemic stroke; for ten or more cerebral microbleeds, aHR 5·52 [3·36–9·05] vs 1·43 [1·07–1
language: eng
source:
identifier: ISSN: ; ISSN: 14744422
fulltext: fulltext_linktorsrc
issn:
  • 14744422
url: Link


@attributes
ID719739298
RANK0.06999999
NO1
SEARCH_ENGINEprimo_central_multiple_fe
SEARCH_ENGINE_TYPEPrimo Central Search Engine
LOCALfalse
PrimoNMBib
record
control
sourcerecordideur:oai:repub.eur.nl:117259
sourceidnarcis
recordidTN_narciseur:oai:repub.eur.nl:117259
sourcesystemOther
pqid2239151432
galeid588834752
display
typearticle
titleCerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies
creatorWilson, D. ; Ambler, G. ; Lee, K.-J. ; Lim, J.-S. ; Shiozawa, M. ; Koga, M. ; Li, L. ; Lovelock, C. ; Chabriat, H. ; Hennerici, Michael ; Wong, Y.K. ; Mak, H.K.F. ; Prats-Sánchez, L. ; Martínez-Domeño, A. ; Inamura, S. ; Yoshifuji, K. ; Arsava, E.M. ; Horstmann, Solveig ; Purrucker, J. ; Lam, B.Y.K. ; Wong, A. ; Kim, Y.D. ; Song, T.-J. ; Schrooten, M. ; Lemmens, R. ; Eppinger, S. ; Gattringer, T. ; Uysal, E. ; Tanriverdi, Z. ; Bornstein, Stefan ; Assayag, E.B. ; Hallevi, H. ; Tanaka, J. ; Hara, H. ; Coutts, S.B. ; Hert, L. ; Polymeris, A. ; Seiffge, D.J. ; Lyrer, Philippe ; Algra, Ale ; Kappelle, Jaap ; Al-Shahi Salman, Rustam ; Jäger, Rolf ; Lip, G.Y.H. ; Mattle, H. ; Panos, L.D. ; Mas, J. ; Legrand, L. ; Karayiannis, C. ; Phan, Thanh ; Gunkel, S. ; Christ, N. ; Abrigo, J. ; Leung, T. ; Chu, W. ; Chappell, F. ; Makin, S. ; Hayden, D. ; Williams, D.J. ; Kooi, M. Eline ; van Dam-Nolen, D.H.K. ; Barbato, C. ; Browning, S. ; Wiegertjes, K. ; Tuladhar, Anil M. ; Maaijwee, N. ; Guevarra, C. ; Yatawara, C. ; Mendyk, A.-M. ; Delmaire, C. ; Köhler, S. ; Oostenbrugge, Robert ; Zhou, Y. ; Xu, C. ; Hilal, Saima ; Gyanwali, B. ; Chen, Christopher ; Lou, M. ; Staals, Julie ; Bordet, R. ; Kandiah, N. ; Leeuw, Frank ; Simister, R. ; Lugt, Aad ; Kelly, P.J. ; Wardlaw, J. ; Soo, Y. ; Fluri, F. ; Srikanth, Velandai ; Calvet, D. ; Jung, S. ; Kwa, V.I.H. ; Engelter, Stefan ; Peters, N. ; Smith, Eric ; Yakushiji, Y. ; Orken, D.N. ; Fazekas, Franz ; Thijs, Vincent ; Heo, J.H. ; Mok, V. ; Veltkamp, Roland ; Ay, H. ; Imaizumi, Toshio ; Gomez-Anson, B. ; Lau, K.K. ; Jouvent, E. ; Rothwell, Peter ; Toyoda, K. ; Bae, H.-J. ; Marti-Fabregas, J. ; Werring, David ; Harkness, K. ; Shaw, L. ; Sword, J. ; Mohd Nor, A. ; Sharma, P. ; Kelly, D. ; Harrington, F. ; Randall, M. ; Smith, M. ; Mahawish, K. ; Elmarim, A. ; Esisi, B. ; Cullen, C. ; Nallasivam, A. ; Price, C. ; Barry, A. ; Roffe, C. ; Coyle, J. ; Hassan, A. ; Birns, J. ; Cohen, D. ; Sekaran, L. ; Parry-Jones, A. ; Parry, A. ; Hargroves, D. ; Proschel, H. ; Datta, P. ; Darawil, K. ; Manoj, A. ; Burn, M. ; Patterson, C. ; Giallombardo, E. ; Smyth, N. ; Mansoor, S. ; Anwar, I. ; Marsh, R. ; Ispoglou, S. ; Chadha, D. ; Prabhakaran, M. ; Meenakishundaram, S. ; O'Connell, J. ; Scott, J. ; Krishnamurthy, V. ; Aghoram, P. ; McCormick, M. ; Sprigg, N. ; O'Mahony, P. ; Cooper, M. ; Choy, L. ; Wilkinson, P. ; Leach, S. ; Caine, S. ; Burger, I. ; Gunathilagan, G. ; Guyler, P. ; Emsley, H. ; Davis, M. ; Manawadu, D. ; Pasco, K. ; Mamun, M. ; Luder, R. ; Sajid, M. ; Okwera, J. ; Warburton, E. ; Saastamoinen, K. ; England, T. ; Putterill, J. ; Flossman, E. ; Power, M. ; Dani, K. ; Mangion, D. ; Suman, A. ; Corrigan, J. ; Lawrence, E. ; Vahidassr, D. ; Shakeshaft, C. ; Brown, M. ; Charidimou, Andreas ; Cohen, H. ; Banerjee, G. ; Houlden, Henry ; White, M. ; Yousry, T. ; Flossmann, E. ; Muir, K. ; El-Koussy, M. ; Gratz, P. ; Molad, J. ; Korczyn, A. ; Kliper, E. ; Maeder, P. ; Gass, A. ; Pachai, C. ; Bracoub, L. ; Douste-Blazy, M.-Y. ; Fratacci, M.D. ; Vicaut, E. ; Sato, S. ; Miwa, K. ; Fujita, K. ; Ide, T. ; Ma, H. ; Ly, J. ; Singhal, S. ; Chandra, R. ; Slater, L.-A. ; Soufan, C. ; Moran, C. ; Traenka, C. ; Thilemann, S. ; Fladt, J. ; Gensicke, Henrik ; Bonati, L. ; Kim, B.J. ; Han, M.-K. ; Kang, J. ; Ko, E. ; Yang, M.H. ; Jang, M.S. ; Murphy, S. ; Carty, F. ; Akijian, L. ; Thornton, J. ; Schembri, M. ; Douven, E. ; Delgado-Mederos;, R. ; Marín, R. ; Camps-Renom, P. ; Guisado-Alonso, D. ; Nuñez, F. ; Medrano-Martorell, S. ; Merino, E. ; Iida, K. ; Ikeda, S. ; Nishihara, M. ; Irie, H. ; Demirelli, D.S. ; Medanta, J.M.
contributorDepartment of Radiology
ispartofThe Lancet Neurology, 2019, Vol.18(7), pp.653-665
identifierISSN: ; ISSN: 14744422
descriptiontextabstractBackground: Cerebral microbleeds are a neuroimaging biomarker of stroke risk. A crucial clinical question is whether cerebral microbleeds indicate patients with recent ischaemic stroke or transient ischaemic attack in whom the rate of future intracranial haemorrhage is likely to exceed that of recurrent ischaemic stroke when treated with antithrombotic drugs. We therefore aimed to establish whether a large burden of cerebral microbleeds or particular anatomical patterns of cerebral microbleeds can identify ischaemic stroke or transient ischaemic attack patients at higher absolute risk of intracranial haemorrhage than ischaemic stroke. Methods: We did a pooled analysis of individual patient data from cohort studies in adults with recent ischaemic stroke or transient ischaemic attack. Cohorts were eligible for inclusion if they prospectively recruited adult participants with ischaemic stroke or transient ischaemic attack; included at least 50 participants; collected data on stroke events over at least 3 months follow-up; used an appropriate MRI sequence that is sensitive to magnetic susceptibility; and documented the number and anatomical distribution of cerebral microbleeds reliably using consensus criteria and validated scales. Our prespecified primary outcomes were a composite of any symptomatic intracranial haemorrhage or ischaemic stroke, symptomatic intracranial haemorrhage, and symptomatic ischaemic stroke. We registered this study with the PROSPERO international prospective register of systematic reviews, number CRD42016036602. Findings: Between Jan 1, 1996, and Dec 1, 2018, we identified 344 studies. After exclusions for ineligibility or declined requests for inclusion, 20 322 patients from 38 cohorts (over 35 225 patient-years of follow-up; median 1·34 years [IQR 0·19–2·44]) were included in our analyses. The adjusted hazard ratio [aHR] comparing patients with cerebral microbleeds to those without was 1·35 (95% CI 1·20–1·50) for the composite outcome of intracranial haemorrhage and ischaemic stroke; 2·45 (1·82–3·29) for intracranial haemorrhage and 1·23 (1·08–1·40) for ischaemic stroke. The aHR increased with increasing cerebral microbleed burden for intracranial haemorrhage but this effect was less marked for ischaemic stroke (for five or more cerebral microbleeds, aHR 4·55 [95% CI 3·08–6·72] for intracranial haemorrhage vs 1·47 [1·19–1·80] for ischaemic stroke; for ten or more cerebral microbleeds, aHR 5·52 [3·36–9·05] vs 1·43 [1·07–1·91]; and for ≥20 cerebral microbleeds, aHR 8·61 [4·69–15·81] vs 1·86 [1·23–1·82]). However, irrespective of cerebral microbleed anatomical distribution or burden, the rate of ischaemic stroke exceeded that of intracranial haemorrhage (for ten or more cerebral microbleeds, 64 ischaemic strokes [95% CI 48–84] per 1000 patient-years vs 27 intracranial haemorrhages [17–41] per 1000 patient-years; and for ≥20 cerebral microbleeds, 73 ischaemic strokes [46–108] per 1000 patient-years vs 39 intracranial haemorrhages [21–67] per 1000 patient-years). Interpretation: In patients with recent ischaemic stroke or transient ischaemic attack, cerebral microbleeds are associated with a greater relative hazard (aHR) for subsequent intracranial haemorrhage than for ischaemic stroke, but the absolute risk of ischaemic stroke is higher than that of intracranial haemorrhage, regardless of cerebral microbleed presence, antomical distribution, or burden. Funding: British Heart Foundation and UK Stroke Association.
languageeng
source
subjectStroke – Risk Factors ; Ischemia – Risk Factors;
version10
oafree_for_read
lds50peer_reviewed
links
openurl$$Topenurl_article
linktorsrc$$Uhttp://hdl.handle.net/1765/117259$$EView_record
openurlfulltext$$Topenurlfull_article
search
creatorcontrib
0Wilson, D.
1Ambler, G.
2Lee, K.-J.
3Lim, J.-S.
4Shiozawa, M.
5Koga, M.
6Li, L.
7Lovelock, C.
8Chabriat, H.
9Hennerici, Michael
10Wong, Y.K.
11Mak, H.K.F.
12Prats-Sánchez, L.
13Martínez-Domeño, A.
14Inamura, S.
15Yoshifuji, K.
16Arsava, E.M.
17Horstmann, Solveig
18Purrucker, J.
19Lam, B.Y.K.
20Wong, A.
21Kim, Y.D.
22Song, T.-J.
23Schrooten, M.
24Lemmens, R.
25Eppinger, S.
26Gattringer, T.
27Uysal, E.
28Tanriverdi, Z.
29Bornstein, Stefan
30Assayag, E.B.
31Hallevi, H.
32Tanaka, J.
33Hara, H.
34Coutts, S.B.
35Hert, L.
36Polymeris, A.
37Seiffge, D.J.
38Lyrer, Philippe
39Algra, Ale
40Kappelle, Jaap
41Al-Shahi Salman, Rustam
42Jäger, Rolf
43Lip, G.Y.H.
44Mattle, H.
45Panos, L.D.
46Mas, J.
47Legrand, L.
48Karayiannis, C.
49Phan, Thanh
50Gunkel, S.
51Christ, N.
52Abrigo, J.
53Leung, T.
54Chu, W.
55Chappell, F.
56Makin, S.
57Hayden, D.
58Williams, D.J.
59Kooi, M. Eline
60van Dam-Nolen, D.H.K.
61Barbato, C.
62Browning, S.
63Wiegertjes, K.
64Tuladhar, Anil M.
65Maaijwee, N.
66Guevarra, C.
67Yatawara, C.
68Mendyk, A.-M.
69Delmaire, C.
70Köhler, S.
71Oostenbrugge, Robert
72Zhou, Y.
73Xu, C.
74Hilal, Saima
75Gyanwali, B.
76Chen, Christopher
77Lou, M.
78Staals, Julie
79Bordet, R.
80Kandiah, N.
81Leeuw, Frank
82Simister, R.
83Lugt, Aad
84Kelly, P.J.
85Wardlaw, J.
86Soo, Y.
87Fluri, F.
88Srikanth, Velandai
89Calvet, D.
90Jung, S.
91Kwa, V.I.H.
92Engelter, Stefan
93Peters, N.
94Smith, Eric
95Yakushiji, Y.
96Orken, D.N.
97Fazekas, Franz
98Thijs, Vincent
99Heo, J.H.
100...
titleCerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies
descriptiontextabstractBackground: Cerebral microbleeds are a neuroimaging biomarker of stroke risk. A crucial clinical question is whether cerebral microbleeds indicate patients with recent ischaemic stroke or transient ischaemic attack in whom the rate of future intracranial haemorrhage is likely to exceed that of recurrent ischaemic stroke when treated with antithrombotic drugs. We therefore aimed to establish whether a large burden of cerebral microbleeds or particular anatomical patterns of cerebral microbleeds can identify ischaemic stroke or transient ischaemic attack patients at higher absolute risk of intracranial haemorrhage than ischaemic stroke. Methods: We did a pooled analysis of individual patient data from cohort studies in adults with recent ischaemic stroke or transient ischaemic attack. Cohorts were eligible for inclusion if they prospectively recruited adult participants with ischaemic stroke or transient ischaemic attack; included at least 50 participants; collected data on stroke events over at least 3 months follow-up; used an appropriate MRI sequence that is sensitive to magnetic susceptibility; and documented the number and anatomical distribution of cerebral microbleeds reliably using consensus criteria and validated scales. Our prespecified primary outcomes were a composite of any symptomatic intracranial haemorrhage or ischaemic stroke, symptomatic intracranial haemorrhage, and symptomatic ischaemic stroke. We registered this study with the PROSPERO international prospective register of systematic reviews, number CRD42016036602. Findings: Between Jan 1, 1996, and Dec 1, 2018, we identified 344 studies. After exclusions for ineligibility or declined requests for inclusion, 20 322 patients from 38 cohorts (over 35 225 patient-years of follow-up; median 1·34 years [IQR 0·19–2·44]) were included in our analyses. The adjusted hazard ratio [aHR] comparing patients with cerebral microbleeds to those without was 1·35 (95% CI 1·20–1·50) for the composite outcome of intracranial haemorrhage and ischaemic stroke; 2·45 (1·82–3·29) for intracranial haemorrhage and 1·23 (1·08–1·40) for ischaemic stroke. The aHR increased with increasing cerebral microbleed burden for intracranial haemorrhage but this effect was less marked for ischaemic stroke (for five or more cerebral microbleeds, aHR 4·55 [95% CI 3·08–6·72] for intracranial haemorrhage vs 1·47 [1·19–1·80] for ischaemic stroke; for ten or more cerebral microbleeds, aHR 5·52 [3·36–9·05] vs 1·43 [1·07–1·91]; and for ≥20 cerebral microbleeds, aHR 8·61 [4·69–15·81] vs 1·86 [1·23–1·82]). However, irrespective of cerebral microbleed anatomical distribution or burden, the rate of ischaemic stroke exceeded that of intracranial haemorrhage (for ten or more cerebral microbleeds, 64 ischaemic strokes [95% CI 48–84] per 1000 patient-years vs 27 intracranial haemorrhages [17–41] per 1000 patient-years; and for ≥20 cerebral microbleeds, 73 ischaemic strokes [46–108] per 1000 patient-years vs 39 intracranial haemorrhages [21–67] per 1000 patient-years). Interpretation: In patients with recent ischaemic stroke or transient ischaemic attack, cerebral microbleeds are associated with a greater relative hazard (aHR) for subsequent intracranial haemorrhage than for ischaemic stroke, but the absolute risk of ischaemic stroke is higher than that of intracranial haemorrhage, regardless of cerebral microbleed presence, antomical distribution, or burden. Funding: British Heart Foundation and UK Stroke Association.
general
0English
1NARCIS (National Academic Research and Collaborations Information System)
2NARCIS (Royal Netherlands Academy of Arts and Sciences)
sourceidnarcis
recordidnarciseur:oai:repub.eur.nl:117259
rsrctypearticle
creationdate2019
searchscope
0narcis
1NARCIS
2NARCIS_oa
scope
0narcis
1NARCIS
2NARCIS_oa
issn14744422
addtitleThe Lancet Neurology
lsr30VSR-Enriched:[doi, subject, pqid, eissn, pages, galeid]
sort
titleCerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies
authorWilson, D. ; Ambler, G. ; Lee, K.-J. ; Lim, J.-S. ; Shiozawa, M. ; Koga, M. ; Li, L. ; Lovelock, C. ; Chabriat, H. ; Hennerici, Michael ; Wong, Y.K. ; Mak, H.K.F. ; Prats-Sánchez, L. ; Martínez-Domeño, A. ; Inamura, S. ; Yoshifuji, K. ; Arsava, E.M. ; Horstmann, Solveig ; Purrucker, J. ; Lam, B.Y.K. ; Wong, A. ; Kim, Y.D. ; Song, T.-J. ; Schrooten, M. ; Lemmens, R. ; Eppinger, S. ; Gattringer, T. ; Uysal, E. ; Tanriverdi, Z. ; Bornstein, Stefan ; Assayag, E.B. ; Hallevi, H. ; Tanaka, J. ; Hara, H. ; Coutts, S.B. ; Hert, L. ; Polymeris, A. ; Seiffge, D.J. ; Lyrer, Philippe ; Algra, Ale ; Kappelle, Jaap ; Al-Shahi Salman, Rustam ; Jäger, Rolf ; Lip, G.Y.H. ; Mattle, H. ; Panos, L.D. ; Mas, J. ; Legrand, L. ; Karayiannis, C. ; Phan, Thanh ; Gunkel, S. ; Christ, N. ; Abrigo, J. ; Leung, T. ; Chu, W. ; Chappell, F. ; Makin, S. ; Hayden, D. ; Williams, D.J. ; Kooi, M. Eline ; van Dam-Nolen, D.H.K. ; Barbato, C. ; Browning, S. ; Wiegertjes, K. ; Tuladhar, Anil M. ; Maaijwee, N. ; Guevarra, C. ; Yatawara, C. ; Mendyk, A.-M. ; Delmaire, C. ; Köhler, S. ; Oostenbrugge, Robert ; Zhou, Y. ; Xu, C. ; Hilal, Saima ; Gyanwali, B. ; Chen, Christopher ; Lou, M. ; Staals, Julie ; Bordet, R. ; Kandiah, N. ; Leeuw, Frank ; Simister, R. ; Lugt, Aad ; Kelly, P.J. ; Wardlaw, J. ; Soo, Y. ; Fluri, F. ; Srikanth, Velandai ; Calvet, D. ; Jung, S. ; Kwa, V.I.H. ; Engelter, Stefan ; Peters, N. ; Smith, Eric ; Yakushiji, Y. ; Orken, D.N. ; Fazekas, Franz ; Thijs, Vincent ; Heo, J.H. ; Mok, V. ; Veltkamp, Roland ; Ay, H. ; Imaizumi, Toshio ; Gomez-Anson, B. ; Lau, K.K. ; Jouvent, E. ; Rothwell, Peter ; Toyoda, K. ; Bae, H.-J. ; Marti-Fabregas, J. ; Werring, David ; Harkness, K. ; Shaw, L. ; Sword, J. ; Mohd Nor, A. ; Sharma, P. ; Kelly, D. ; Harrington, F. ; Randall, M. ; Smith, M. ; Mahawish, K. ; Elmarim, A. ; Esisi, B. ; Cullen, C. ; Nallasivam, A. ; Price, C. ; Barry, A. ; Roffe, C. ; Coyle, J. ; Hassan, A. ; Birns, J. ; Cohen, D. ; Sekaran, L. ; Parry-Jones, A. ; Parry, A. ; Hargroves, D. ; Proschel, H. ; Datta, P. ; Darawil, K. ; Manoj, A. ; Burn, M. ; Patterson, C. ; Giallombardo, E. ; Smyth, N. ; Mansoor, S. ; Anwar, I. ; Marsh, R. ; Ispoglou, S. ; Chadha, D. ; Prabhakaran, M. ; Meenakishundaram, S. ; O'Connell, J. ; Scott, J. ; Krishnamurthy, V. ; Aghoram, P. ; McCormick, M. ; Sprigg, N. ; O'Mahony, P. ; Cooper, M. ; Choy, L. ; Wilkinson, P. ; Leach, S. ; Caine, S. ; Burger, I. ; Gunathilagan, G. ; Guyler, P. ; Emsley, H. ; Davis, M. ; Manawadu, D. ; Pasco, K. ; Mamun, M. ; Luder, R. ; Sajid, M. ; Okwera, J. ; Warburton, E. ; Saastamoinen, K. ; England, T. ; Putterill, J. ; Flossman, E. ; Power, M. ; Dani, K. ; Mangion, D. ; Suman, A. ; Corrigan, J. ; Lawrence, E. ; Vahidassr, D. ; Shakeshaft, C. ; Brown, M. ; Charidimou, Andreas ; Cohen, H. ; Banerjee, G. ; Houlden, Henry ; White, M. ; Yousry, T. ; Flossmann, E. ; Muir, K. ; El-Koussy, M. ; Gratz, P. ; Molad, J. ; Korczyn, A. ; Kliper, E. ; Maeder, P. ; Gass, A. ; Pachai, C. ; Bracoub, L. ; Douste-Blazy, M.-Y. ; Fratacci, M.D. ; Vicaut, E. ; Sato, S. ; Miwa, K. ; Fujita, K. ; Ide, T. ; Ma, H. ; Ly, J. ; Singhal, S. ; Chandra, R. ; Slater, L.-A. ; Soufan, C. ; Moran, C. ; Traenka, C. ; Thilemann, S. ; Fladt, J. ; Gensicke, Henrik ; Bonati, L. ; Kim, B.J. ; Han, M.-K. ; Kang, J. ; Ko, E. ; Yang, M.H. ; Jang, M.S. ; Murphy, S. ; Carty, F. ; Akijian, L. ; Thornton, J. ; Schembri, M. ; Douven, E. ; Delgado-Mederos;, R. ; Marín, R. ; Camps-Renom, P. ; Guisado-Alonso, D. ; Nuñez, F. ; Medrano-Martorell, S. ; Merino, E. ; Iida, K. ; Ikeda, S. ; Nishihara, M. ; Irie, H. ; Demirelli, D.S. ; Medanta, J.M.
creationdate20190701
facets
frbrgroupid6758468686207615620
frbrtype5
newrecords20190710
languageeng
creationdate2019
collectionNARCIS (Royal Netherlands Academy of Arts and Sciences)
prefilterarticles
rsrctypearticles
creatorcontrib
0Wilson, D.
1Ambler, G.
2Lee, K.-J.
3Lim, J.-S.
4Shiozawa, M.
5Koga, M.
6Li, L.
7Lovelock, C.
8Chabriat, H.
9Hennerici, Michael
10Wong, Y.K.
11Mak, H.K.F.
12Prats-Sánchez, L.
13Martínez-Domeño, A.
14Inamura, S.
15Yoshifuji, K.
16Arsava, E.M.
17Horstmann, Solveig
18Purrucker, J.
19Lam, B.Y.K.
20Wong, A.
21Kim, Y.D.
22Song, T.-J.
23Schrooten, M.
24Lemmens, R.
25Eppinger, S.
26Gattringer, T.
27Uysal, E.
28Tanriverdi, Z.
29Bornstein, Stefan
30Assayag, E.B.
31Hallevi, H.
32Tanaka, J.
33Hara, H.
34Coutts, S.B.
35Hert, L.
36Polymeris, A.
37Seiffge, D.J.
38Lyrer, Philippe
39Algra, Ale
40Kappelle, Jaap
41Al-Shahi Salman, Rustam
42Jäger, Rolf
43Lip, G.Y.H.
44Mattle, H.
45Panos, L.D.
46Mas, J.
47Legrand, L.
48Karayiannis, C.
49Phan, Thanh
50Gunkel, S.
51Christ, N.
52Abrigo, J.
53Leung, T.
54Chu, W.
55Chappell, F.
56Makin, S.
57Hayden, D.
58Williams, D.J.
59Kooi, M. Eline
60van Dam-Nolen, D.H.K.
61Barbato, C.
62Browning, S.
63Wiegertjes, K.
64Tuladhar, Anil M.
65Maaijwee, N.
66Guevarra, C.
67Yatawara, C.
68Mendyk, A.-M.
69Delmaire, C.
70Köhler, S.
71Oostenbrugge, Robert
72Zhou, Y.
73Xu, C.
74Hilal, Saima
75Gyanwali, B.
76Chen, Christopher
77Lou, M.
78Staals, Julie
79Bordet, R.
80Kandiah, N.
81Leeuw, Frank
82Simister, R.
83Lugt, Aad
84Kelly, P.J.
85Wardlaw, J.
86Soo, Y.
87Fluri, F.
88Srikanth, Velandai
89Calvet, D.
90Jung, S.
91Kwa, V.I.H.
92Engelter, Stefan
93Peters, N.
94Smith, Eric
95Yakushiji, Y.
96Orken, D.N.
97Fazekas, Franz
98Thijs, Vincent
99Heo, J.H.
100...
jtitleLancet Neurology
toplevelpeer_reviewed
delivery
delcategoryRemote Search Resource
fulltextfulltext_linktorsrc
addata
au
0Wilson, D.
1Ambler, G.
2Lee, K.-J.
3Lim, J.-S.
4Shiozawa, M.
5Koga, M.
6Li, L.
7Lovelock, C.
8Chabriat, H.
9Hennerici, Michael
10Wong, Y.K.
11Mak, H.K.F.
12Prats-Sánchez, L.
13Martínez-Domeño, A.
14Inamura, S.
15Yoshifuji, K.
16Arsava, E.M.
17Horstmann, Solveig
18Purrucker, J.
19Lam, B.Y.K.
20Wong, A.
21Kim, Y.D.
22Song, T.-J.
23Schrooten, M.
24Lemmens, R.
25Eppinger, S.
26Gattringer, T.
27Uysal, E.
28Tanriverdi, Z.
29Bornstein, Stefan
30Assayag, E.B.
31Hallevi, H.
32Tanaka, J.
33Hara, H.
34Coutts, S.B.
35Hert, L.
36Polymeris, A.
37Seiffge, D.J.
38Lyrer, Philippe
39Algra, Ale
40Kappelle, Jaap
41Al-Shahi Salman, Rustam
42Jäger, Rolf
43Lip, G.Y.H.
44Mattle, H.
45Panos, L.D.
46Mas, J.
47Legrand, L.
48Karayiannis, C.
49Phan, Thanh
50Gunkel, S.
51Christ, N.
52Abrigo, J.
53Leung, T.
54Chu, W.
55Chappell, F.
56Makin, S.
57Hayden, D.
58Williams, D.J.
59Kooi, M. Eline
60van Dam-Nolen, D.H.K.
61Barbato, C.
62Browning, S.
63Wiegertjes, K.
64Tuladhar, Anil M.
65Maaijwee, N.
66Guevarra, C.
67Yatawara, C.
68Mendyk, A.-M.
69Delmaire, C.
70Köhler, S.
71Oostenbrugge, Robert
72Zhou, Y.
73Xu, C.
74Hilal, Saima
75Gyanwali, B.
76Chen, Christopher
77Lou, M.
78Staals, Julie
79Bordet, R.
80Kandiah, N.
81Leeuw, Frank
82Simister, R.
83Lugt, Aad
84Kelly, P.J.
85Wardlaw, J.
86Soo, Y.
87Fluri, F.
88Srikanth, Velandai
89Calvet, D.
90Jung, S.
91Kwa, V.I.H.
92Engelter, Stefan
93Peters, N.
94Smith, Eric
95Yakushiji, Y.
96Orken, D.N.
97Fazekas, Franz
98Thijs, Vincent
99Heo, J.H.
100...
addauDepartment of Radiology
atitleCerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies
jtitleThe Lancet Neurology
risdate20190701
volume18
issue7
spage653
epage665
issn14744422
genrearticle
ristypeJOUR
doi10.1016/S1474-4422(19)30197-8
pages653-665
eissn14744465
oafree_for_read
date2019-07-01