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Small vessel disease and clinical outcomes after IV rt-PA treatment

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Small vessel disease and clinical outcomes after IV rt-PA treatment. / Arba, F; Inzitari, D; Ali, M; Warach, S J; Luby, M; Lees, K R; STIR/VISTA Imaging Collaboration.

in: ACTA NEUROL SCAND, Jahrgang 136, Nr. 1, 07.2017, S. 72-77.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Arba, F, Inzitari, D, Ali, M, Warach, SJ, Luby, M, Lees, KR & STIR/VISTA Imaging Collaboration 2017, 'Small vessel disease and clinical outcomes after IV rt-PA treatment', ACTA NEUROL SCAND, Jg. 136, Nr. 1, S. 72-77. https://doi.org/10.1111/ane.12745

APA

Arba, F., Inzitari, D., Ali, M., Warach, S. J., Luby, M., Lees, K. R., & STIR/VISTA Imaging Collaboration (2017). Small vessel disease and clinical outcomes after IV rt-PA treatment. ACTA NEUROL SCAND, 136(1), 72-77. https://doi.org/10.1111/ane.12745

Vancouver

Arba F, Inzitari D, Ali M, Warach SJ, Luby M, Lees KR et al. Small vessel disease and clinical outcomes after IV rt-PA treatment. ACTA NEUROL SCAND. 2017 Jul;136(1):72-77. https://doi.org/10.1111/ane.12745

Bibtex

@article{e2a83975822f449d9c1e6824c565fc12,
title = "Small vessel disease and clinical outcomes after IV rt-PA treatment",
abstract = "INTRODUCTION: Cerebral small vessel disease (SVD) contributes to dementia and disability in the elderly, and may negatively affect stroke outcomes. We aimed to evaluate to what extent single features and global burden of SVD detected with magnetic resonance (MR) are associated with worse outcomes in patients with ischaemic stroke treated with intravenous thrombolysis.METHODS: We accessed anonymized data and MR images from the Stroke Imaging Repository (STIR) and the Virtual International Stroke Trials Archive (VISTA) Imaging. We described SVD features using validated scales and quantified the global burden of SVD with a combined score. Our mainoutcome was the modified Rankin Scale (mRS) at 90 days after stroke. We used logistic regression and ordinal regression models (adjusted for age, sex, stroke severity, onset to treatment time) to examine the associations between each SVD feature, SVD global burden and clinical outcomes.RESULTS: A total of 259 patients had MR scans available at baseline (mean age±SD=68.7±15.5 years; 131 [49%] males). After adjustment for confounders, severe white matter changes were associated with disability (OR=5.14; 95%CI=2.30-11.48), functional dependency (OR=4.38; 95%CI=2.10-9.13) and worse outcomes in ordinal analysis (OR=2.71; 95%CI=1.25-5.85). SVD score was associated with disability (OR=1.66; 95%CI=1.03-2.66) and functional dependency (OR=1.47; 95%CI=1.00-2.45). Lacunes, enlarged perivascular spaces and brain atrophy showed no association with clinical outcomes.CONCLUSION: Our results suggest that SVD negatively affects stroke outcomes after intravenous thrombolysis. Although white matter changes seem to be the major driver in relation to worse outcomes, global estimation of SVD is feasible and may provide helpful information.",
keywords = "Aged, Aged, 80 and over, Cerebral Small Vessel Diseases, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Stroke, Tissue Plasminogen Activator, Journal Article",
author = "F Arba and D Inzitari and M Ali and Warach, {S J} and M Luby and Lees, {K R} and {STIR/VISTA Imaging Collaboration}",
note = "{\textcopyright} 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.",
year = "2017",
month = jul,
doi = "10.1111/ane.12745",
language = "English",
volume = "136",
pages = "72--77",
journal = "ACTA NEUROL SCAND",
issn = "0001-6314",
publisher = "Wiley-Blackwell",
number = "1",

}

RIS

TY - JOUR

T1 - Small vessel disease and clinical outcomes after IV rt-PA treatment

AU - Arba, F

AU - Inzitari, D

AU - Ali, M

AU - Warach, S J

AU - Luby, M

AU - Lees, K R

AU - STIR/VISTA Imaging Collaboration

N1 - © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PY - 2017/7

Y1 - 2017/7

N2 - INTRODUCTION: Cerebral small vessel disease (SVD) contributes to dementia and disability in the elderly, and may negatively affect stroke outcomes. We aimed to evaluate to what extent single features and global burden of SVD detected with magnetic resonance (MR) are associated with worse outcomes in patients with ischaemic stroke treated with intravenous thrombolysis.METHODS: We accessed anonymized data and MR images from the Stroke Imaging Repository (STIR) and the Virtual International Stroke Trials Archive (VISTA) Imaging. We described SVD features using validated scales and quantified the global burden of SVD with a combined score. Our mainoutcome was the modified Rankin Scale (mRS) at 90 days after stroke. We used logistic regression and ordinal regression models (adjusted for age, sex, stroke severity, onset to treatment time) to examine the associations between each SVD feature, SVD global burden and clinical outcomes.RESULTS: A total of 259 patients had MR scans available at baseline (mean age±SD=68.7±15.5 years; 131 [49%] males). After adjustment for confounders, severe white matter changes were associated with disability (OR=5.14; 95%CI=2.30-11.48), functional dependency (OR=4.38; 95%CI=2.10-9.13) and worse outcomes in ordinal analysis (OR=2.71; 95%CI=1.25-5.85). SVD score was associated with disability (OR=1.66; 95%CI=1.03-2.66) and functional dependency (OR=1.47; 95%CI=1.00-2.45). Lacunes, enlarged perivascular spaces and brain atrophy showed no association with clinical outcomes.CONCLUSION: Our results suggest that SVD negatively affects stroke outcomes after intravenous thrombolysis. Although white matter changes seem to be the major driver in relation to worse outcomes, global estimation of SVD is feasible and may provide helpful information.

AB - INTRODUCTION: Cerebral small vessel disease (SVD) contributes to dementia and disability in the elderly, and may negatively affect stroke outcomes. We aimed to evaluate to what extent single features and global burden of SVD detected with magnetic resonance (MR) are associated with worse outcomes in patients with ischaemic stroke treated with intravenous thrombolysis.METHODS: We accessed anonymized data and MR images from the Stroke Imaging Repository (STIR) and the Virtual International Stroke Trials Archive (VISTA) Imaging. We described SVD features using validated scales and quantified the global burden of SVD with a combined score. Our mainoutcome was the modified Rankin Scale (mRS) at 90 days after stroke. We used logistic regression and ordinal regression models (adjusted for age, sex, stroke severity, onset to treatment time) to examine the associations between each SVD feature, SVD global burden and clinical outcomes.RESULTS: A total of 259 patients had MR scans available at baseline (mean age±SD=68.7±15.5 years; 131 [49%] males). After adjustment for confounders, severe white matter changes were associated with disability (OR=5.14; 95%CI=2.30-11.48), functional dependency (OR=4.38; 95%CI=2.10-9.13) and worse outcomes in ordinal analysis (OR=2.71; 95%CI=1.25-5.85). SVD score was associated with disability (OR=1.66; 95%CI=1.03-2.66) and functional dependency (OR=1.47; 95%CI=1.00-2.45). Lacunes, enlarged perivascular spaces and brain atrophy showed no association with clinical outcomes.CONCLUSION: Our results suggest that SVD negatively affects stroke outcomes after intravenous thrombolysis. Although white matter changes seem to be the major driver in relation to worse outcomes, global estimation of SVD is feasible and may provide helpful information.

KW - Aged

KW - Aged, 80 and over

KW - Cerebral Small Vessel Diseases

KW - Female

KW - Humans

KW - Magnetic Resonance Imaging

KW - Male

KW - Middle Aged

KW - Stroke

KW - Tissue Plasminogen Activator

KW - Journal Article

U2 - 10.1111/ane.12745

DO - 10.1111/ane.12745

M3 - SCORING: Journal article

C2 - 28233290

VL - 136

SP - 72

EP - 77

JO - ACTA NEUROL SCAND

JF - ACTA NEUROL SCAND

SN - 0001-6314

IS - 1

ER -