Global Brain Perfusion and the Risk of Transient Ischemic Attack and Ischemic Stroke: The Rotterdam Study
Background The role of subtle disturbances of brain perfusion in the risk of transient ischemic attack (TIA) or ischemic stroke remains unknown. We examined the association between global brain perfusion and risk of TIA and ischemic stroke in the general population. Methods and Results Between 2005...
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| Format: | Article |
| Language: | English |
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Wiley
2019-04-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.118.011565 |
| _version_ | 1819178189050609664 |
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| author | Lana Fani Daniel Bos Unal Mutlu Marileen L.P. Portegies Hazel I. Zonneveld Peter J. Koudstaal Meike W. Vernooij M. Arfan Ikram M. Kamran Ikram |
| author_facet | Lana Fani Daniel Bos Unal Mutlu Marileen L.P. Portegies Hazel I. Zonneveld Peter J. Koudstaal Meike W. Vernooij M. Arfan Ikram M. Kamran Ikram |
| author_sort | Lana Fani |
| collection | DOAJ |
| description | Background The role of subtle disturbances of brain perfusion in the risk of transient ischemic attack (TIA) or ischemic stroke remains unknown. We examined the association between global brain perfusion and risk of TIA and ischemic stroke in the general population. Methods and Results Between 2005 and 2015, 5289 stroke‐free participants (mean age, 64.3 years; 55.6% women) from the Rotterdam Study underwent phase‐contrast brain magnetic resonance imaging at baseline to assess global brain perfusion. These participants were followed for incident TIA or ischemic stroke until January 1, 2016. We investigated associations between global brain perfusion (mL of blood flow/100 mL of brain/min) and risk of TIA and ischemic stroke using Cox regression models with adjustment for age, sex, and cardiovascular risk factors. Additionally, we investigated whether associations were modified by retinal vessel calibers, small and large vessel disease, blood pressure, and heart rate. During a median follow‐up of 7.2 years (36 103 person‐years), 137 participants suffered a TIA and another 108 an ischemic stroke. We found that lower global brain perfusion was associated with a higher risk of TIA, but not with the risk of ischemic stroke (adjusted hazard ratio, 95% CI, per standard deviation decrease of global brain perfusion: 1.29, 1.07–1.55 for TIA and adjusted hazard ratio of 1.06, 0.87–1.30 for ischemic stroke). Across strata of wider arteriolar retinal calibers, lower brain perfusion was more prominently associated with TIA, but not with ischemic stroke. Conclusions In a community‐dwelling population, impaired global brain perfusion increased the risk of TIA, but not of ischemic stroke. |
| first_indexed | 2024-12-22T21:38:35Z |
| format | Article |
| id | doaj.art-71c72fa9d984471ea630dc0d957bc5ed |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-22T21:38:35Z |
| publishDate | 2019-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-71c72fa9d984471ea630dc0d957bc5ed2022-12-21T18:11:40ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802019-04-018710.1161/JAHA.118.011565Global Brain Perfusion and the Risk of Transient Ischemic Attack and Ischemic Stroke: The Rotterdam StudyLana Fani0Daniel Bos1Unal Mutlu2Marileen L.P. Portegies3Hazel I. Zonneveld4Peter J. Koudstaal5Meike W. Vernooij6M. Arfan Ikram7M. Kamran Ikram8Department of Epidemiology Erasmus MC University Medical Center Rotterdam the NetherlandsDepartment of Epidemiology Erasmus MC University Medical Center Rotterdam the NetherlandsDepartment of Epidemiology Erasmus MC University Medical Center Rotterdam the NetherlandsDepartment of Epidemiology Erasmus MC University Medical Center Rotterdam the NetherlandsDepartment of Epidemiology Erasmus MC University Medical Center Rotterdam the NetherlandsDepartment of Neurology Erasmus MC University Medical Center Rotterdam the NetherlandsDepartment of Epidemiology Erasmus MC University Medical Center Rotterdam the NetherlandsDepartment of Epidemiology Erasmus MC University Medical Center Rotterdam the NetherlandsDepartment of Epidemiology Erasmus MC University Medical Center Rotterdam the NetherlandsBackground The role of subtle disturbances of brain perfusion in the risk of transient ischemic attack (TIA) or ischemic stroke remains unknown. We examined the association between global brain perfusion and risk of TIA and ischemic stroke in the general population. Methods and Results Between 2005 and 2015, 5289 stroke‐free participants (mean age, 64.3 years; 55.6% women) from the Rotterdam Study underwent phase‐contrast brain magnetic resonance imaging at baseline to assess global brain perfusion. These participants were followed for incident TIA or ischemic stroke until January 1, 2016. We investigated associations between global brain perfusion (mL of blood flow/100 mL of brain/min) and risk of TIA and ischemic stroke using Cox regression models with adjustment for age, sex, and cardiovascular risk factors. Additionally, we investigated whether associations were modified by retinal vessel calibers, small and large vessel disease, blood pressure, and heart rate. During a median follow‐up of 7.2 years (36 103 person‐years), 137 participants suffered a TIA and another 108 an ischemic stroke. We found that lower global brain perfusion was associated with a higher risk of TIA, but not with the risk of ischemic stroke (adjusted hazard ratio, 95% CI, per standard deviation decrease of global brain perfusion: 1.29, 1.07–1.55 for TIA and adjusted hazard ratio of 1.06, 0.87–1.30 for ischemic stroke). Across strata of wider arteriolar retinal calibers, lower brain perfusion was more prominently associated with TIA, but not with ischemic stroke. Conclusions In a community‐dwelling population, impaired global brain perfusion increased the risk of TIA, but not of ischemic stroke.https://www.ahajournals.org/doi/10.1161/JAHA.118.011565perfusionpopulation studiesprospective cohort studystroketransient ischemic attack |
| spellingShingle | Lana Fani Daniel Bos Unal Mutlu Marileen L.P. Portegies Hazel I. Zonneveld Peter J. Koudstaal Meike W. Vernooij M. Arfan Ikram M. Kamran Ikram Global Brain Perfusion and the Risk of Transient Ischemic Attack and Ischemic Stroke: The Rotterdam Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease perfusion population studies prospective cohort study stroke transient ischemic attack |
| title | Global Brain Perfusion and the Risk of Transient Ischemic Attack and Ischemic Stroke: The Rotterdam Study |
| title_full | Global Brain Perfusion and the Risk of Transient Ischemic Attack and Ischemic Stroke: The Rotterdam Study |
| title_fullStr | Global Brain Perfusion and the Risk of Transient Ischemic Attack and Ischemic Stroke: The Rotterdam Study |
| title_full_unstemmed | Global Brain Perfusion and the Risk of Transient Ischemic Attack and Ischemic Stroke: The Rotterdam Study |
| title_short | Global Brain Perfusion and the Risk of Transient Ischemic Attack and Ischemic Stroke: The Rotterdam Study |
| title_sort | global brain perfusion and the risk of transient ischemic attack and ischemic stroke the rotterdam study |
| topic | perfusion population studies prospective cohort study stroke transient ischemic attack |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.118.011565 |
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