Dolichoectasia and Small Vessel Disease in Young Patients With Transient Ischemic Attack and Stroke
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Dolichoectasia and Small Vessel Disease in Young Patients With Transient Ischemic Attack and Stroke. / Stroke in Fabry (SIFAP1) Investigators.
in: STROKE, Jahrgang 48, Nr. 9, 09.2017, S. 2361-2367.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Dolichoectasia and Small Vessel Disease in Young Patients With Transient Ischemic Attack and Stroke
AU - Thijs, Vincent
AU - Grittner, Ulrike
AU - Fazekas, Franz
AU - McCabe, Dominick J H
AU - Giese, Anne-Katrin
AU - Kessler, Christof
AU - Martus, Peter
AU - Norrving, Bo
AU - Ringelstein, Erich Bernd
AU - Schmidt, Reinhold
AU - Tanislav, Christian
AU - Putaala, Jukka
AU - Tatlisumak, Turgut
AU - von Sarnowski, Bettina
AU - Rolfs, Arndt
AU - Enzinger, Christian
AU - Stroke in Fabry (SIFAP1) Investigators
N1 - © 2017 American Heart Association, Inc.
PY - 2017/9
Y1 - 2017/9
N2 - BACKGROUND AND PURPOSE: We evaluated whether basilar dolichoectasia is associated with markers of cerebral small vessel disease in younger transient ischemic attack and ischemic stroke patients.METHODS: We used data from the SIFAP1 study (Stroke in Young Fabry Patients), a large prospective, hospital-based, screening study for Fabry disease in young (<55 years) transient ischemic attack/stroke patients in whom detailed clinical data and brain MRI were obtained, and stroke subtyping with TOAST classification (Trial of ORG 10172 in Acute Stroke Treatment) was performed.RESULTS: Dolichoectasia was found in 508 of 3850 (13.2%) of patients. Dolichoectasia was associated with older age (odds ratio per decade, 1.26; 95% confidence interval, 1.09-1.44), male sex (odds ratio, 1.96; 95% confidence interval, 1.59-2.42), and hypertension (odds ratio, 1.39; 95% confidence interval, 1.13-1.70). Dolichoectasia was more common in patients with small infarctions (33.9% versus 29.8% for acute lesions, P=0.065; 29.1% versus 16.5% for old lesions, P<0.001), infarct location in the brain stem (12.4% versus 6.9%, P<0.001), and in white matter (27.8% versus 21.1%, P=0.001). Microbleeds (16.3% versus 4.7%, P=0.001), higher grades of white matter hyperintensities (P<0.001), and small vessel disease subtype (18.1% versus 12.4%, overall P for differences in TOAST (P=0.018) were more often present in patients with dolichoectasia.CONCLUSIONS: Dolichoectasia is associated with imaging markers of small vessel disease and brain stem localization of acute and old infarcts in younger patients with transient ischemic attack and ischemic stroke.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00414583.
AB - BACKGROUND AND PURPOSE: We evaluated whether basilar dolichoectasia is associated with markers of cerebral small vessel disease in younger transient ischemic attack and ischemic stroke patients.METHODS: We used data from the SIFAP1 study (Stroke in Young Fabry Patients), a large prospective, hospital-based, screening study for Fabry disease in young (<55 years) transient ischemic attack/stroke patients in whom detailed clinical data and brain MRI were obtained, and stroke subtyping with TOAST classification (Trial of ORG 10172 in Acute Stroke Treatment) was performed.RESULTS: Dolichoectasia was found in 508 of 3850 (13.2%) of patients. Dolichoectasia was associated with older age (odds ratio per decade, 1.26; 95% confidence interval, 1.09-1.44), male sex (odds ratio, 1.96; 95% confidence interval, 1.59-2.42), and hypertension (odds ratio, 1.39; 95% confidence interval, 1.13-1.70). Dolichoectasia was more common in patients with small infarctions (33.9% versus 29.8% for acute lesions, P=0.065; 29.1% versus 16.5% for old lesions, P<0.001), infarct location in the brain stem (12.4% versus 6.9%, P<0.001), and in white matter (27.8% versus 21.1%, P=0.001). Microbleeds (16.3% versus 4.7%, P=0.001), higher grades of white matter hyperintensities (P<0.001), and small vessel disease subtype (18.1% versus 12.4%, overall P for differences in TOAST (P=0.018) were more often present in patients with dolichoectasia.CONCLUSIONS: Dolichoectasia is associated with imaging markers of small vessel disease and brain stem localization of acute and old infarcts in younger patients with transient ischemic attack and ischemic stroke.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00414583.
KW - Adult
KW - Age Factors
KW - Brain Stem Infarctions/epidemiology
KW - Cerebral Hemorrhage/epidemiology
KW - Cerebral Small Vessel Diseases/diagnostic imaging
KW - Female
KW - Humans
KW - Hypertension/epidemiology
KW - Ischemic Attack, Transient/epidemiology
KW - Magnetic Resonance Imaging
KW - Male
KW - Middle Aged
KW - Odds Ratio
KW - Risk Factors
KW - Sex Factors
KW - Stroke/epidemiology
KW - Vertebrobasilar Insufficiency/diagnostic imaging
KW - White Matter/blood supply
U2 - 10.1161/STROKEAHA.117.017406
DO - 10.1161/STROKEAHA.117.017406
M3 - SCORING: Journal article
C2 - 28754833
VL - 48
SP - 2361
EP - 2367
JO - STROKE
JF - STROKE
SN - 0039-2499
IS - 9
ER -
