Recurrent stroke risk and cerebral microbleed burden in ischemic stroke and TIA: A meta-analysis
To determine associations between cerebral microbleed (CMB) burden with recurrent ischemic stroke (IS) and intracerebral hemorrhage (ICH) risk after IS or TIA. We identified prospective studies of patients with IS or TIA that investigated CMBs and stroke (ICH and IS) risk during ≥3 months follow-up....
| Asıl Yazarlar: | , , , , , , , , , , , , , , , , , , , |
|---|---|
| Materyal Türü: | Journal article |
| Dil: | English |
| Baskı/Yayın Bilgisi: |
American Academy of Neurology
2016
|
| _version_ | 1826285015633231872 |
|---|---|
| author | Wilson, D Charidimou, A Ambler, G Fox, Z Gregoire, S Rayson, P Imaizumi, T Fluri, F Naka, H Horstmann, S Veltkamp, R Rothwell, P Kwa, V Thijs, V Lee, Y Kim, Y Huang, Y Wong, K Jäger, H Werring, D |
| author_facet | Wilson, D Charidimou, A Ambler, G Fox, Z Gregoire, S Rayson, P Imaizumi, T Fluri, F Naka, H Horstmann, S Veltkamp, R Rothwell, P Kwa, V Thijs, V Lee, Y Kim, Y Huang, Y Wong, K Jäger, H Werring, D |
| author_sort | Wilson, D |
| collection | OXFORD |
| description | To determine associations between cerebral microbleed (CMB) burden with recurrent ischemic stroke (IS) and intracerebral hemorrhage (ICH) risk after IS or TIA. We identified prospective studies of patients with IS or TIA that investigated CMBs and stroke (ICH and IS) risk during ≥3 months follow-up. Authors provided aggregate summary-level data on stroke outcomes, with CMBs categorized according to burden (single, 2-4, and ≥5 CMBs) and distribution. We calculated absolute event rates and pooled risk ratios (RR) using random-effects meta-analysis.We included 5,068 patients from 15 studies. There were 115/1,284 (9.6%) recurrent IS events in patients with CMBs vs 212/3,781 (5.6%) in patients without CMBs (pooled RR 1.8 for CMBs vs no CMBs; 95% confidence interval [CI] 1.4-2.5). There were 49/1,142 (4.3%) ICH events in those with CMBs vs 17/2,912 (0.58%) in those without CMBs (pooled RR 6.3 for CMBs vs no CMBs; 95% CI 3.5-11.4). Increasing CMB burden increased the risk of IS (pooled RR [95% CI] 1.8 [1.0-3.1], 2.4 [1.3-4.4], and 2.7 [1.5-4.9] for 1 CMB, 2-4 CMBs, and ≥5 CMBs, respectively) and ICH (pooled RR [95% CI] 4.6 [1.9-10.7], 5.6 [2.4-13.3], and 14.1 [6.9-29.0] for 1 CMB, 2-4 CMBs, and ≥5 CMBs, respectively). CMBs are associated with increased stroke risk after IS or TIA. With increasing CMB burden (compared to no CMBs), the risk of ICH increases more steeply than that of IS. However, IS absolute event rates remain higher than ICH absolute event rates in all CMB burden categories. |
| first_indexed | 2024-03-07T01:22:31Z |
| format | Journal article |
| id | oxford-uuid:90d4e3d5-cf81-4e57-980e-1b58d1ab20c0 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T01:22:31Z |
| publishDate | 2016 |
| publisher | American Academy of Neurology |
| record_format | dspace |
| spelling | oxford-uuid:90d4e3d5-cf81-4e57-980e-1b58d1ab20c02022-03-26T23:14:43ZRecurrent stroke risk and cerebral microbleed burden in ischemic stroke and TIA: A meta-analysisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:90d4e3d5-cf81-4e57-980e-1b58d1ab20c0EnglishSymplectic Elements at OxfordAmerican Academy of Neurology2016Wilson, DCharidimou, AAmbler, GFox, ZGregoire, SRayson, PImaizumi, TFluri, FNaka, HHorstmann, SVeltkamp, RRothwell, PKwa, VThijs, VLee, YKim, YHuang, YWong, KJäger, HWerring, DTo determine associations between cerebral microbleed (CMB) burden with recurrent ischemic stroke (IS) and intracerebral hemorrhage (ICH) risk after IS or TIA. We identified prospective studies of patients with IS or TIA that investigated CMBs and stroke (ICH and IS) risk during ≥3 months follow-up. Authors provided aggregate summary-level data on stroke outcomes, with CMBs categorized according to burden (single, 2-4, and ≥5 CMBs) and distribution. We calculated absolute event rates and pooled risk ratios (RR) using random-effects meta-analysis.We included 5,068 patients from 15 studies. There were 115/1,284 (9.6%) recurrent IS events in patients with CMBs vs 212/3,781 (5.6%) in patients without CMBs (pooled RR 1.8 for CMBs vs no CMBs; 95% confidence interval [CI] 1.4-2.5). There were 49/1,142 (4.3%) ICH events in those with CMBs vs 17/2,912 (0.58%) in those without CMBs (pooled RR 6.3 for CMBs vs no CMBs; 95% CI 3.5-11.4). Increasing CMB burden increased the risk of IS (pooled RR [95% CI] 1.8 [1.0-3.1], 2.4 [1.3-4.4], and 2.7 [1.5-4.9] for 1 CMB, 2-4 CMBs, and ≥5 CMBs, respectively) and ICH (pooled RR [95% CI] 4.6 [1.9-10.7], 5.6 [2.4-13.3], and 14.1 [6.9-29.0] for 1 CMB, 2-4 CMBs, and ≥5 CMBs, respectively). CMBs are associated with increased stroke risk after IS or TIA. With increasing CMB burden (compared to no CMBs), the risk of ICH increases more steeply than that of IS. However, IS absolute event rates remain higher than ICH absolute event rates in all CMB burden categories. |
| spellingShingle | Wilson, D Charidimou, A Ambler, G Fox, Z Gregoire, S Rayson, P Imaizumi, T Fluri, F Naka, H Horstmann, S Veltkamp, R Rothwell, P Kwa, V Thijs, V Lee, Y Kim, Y Huang, Y Wong, K Jäger, H Werring, D Recurrent stroke risk and cerebral microbleed burden in ischemic stroke and TIA: A meta-analysis |
| title | Recurrent stroke risk and cerebral microbleed burden in ischemic stroke and TIA: A meta-analysis |
| title_full | Recurrent stroke risk and cerebral microbleed burden in ischemic stroke and TIA: A meta-analysis |
| title_fullStr | Recurrent stroke risk and cerebral microbleed burden in ischemic stroke and TIA: A meta-analysis |
| title_full_unstemmed | Recurrent stroke risk and cerebral microbleed burden in ischemic stroke and TIA: A meta-analysis |
| title_short | Recurrent stroke risk and cerebral microbleed burden in ischemic stroke and TIA: A meta-analysis |
| title_sort | recurrent stroke risk and cerebral microbleed burden in ischemic stroke and tia a meta analysis |
| work_keys_str_mv | AT wilsond recurrentstrokeriskandcerebralmicrobleedburdeninischemicstrokeandtiaametaanalysis AT charidimoua recurrentstrokeriskandcerebralmicrobleedburdeninischemicstrokeandtiaametaanalysis AT amblerg recurrentstrokeriskandcerebralmicrobleedburdeninischemicstrokeandtiaametaanalysis AT foxz recurrentstrokeriskandcerebralmicrobleedburdeninischemicstrokeandtiaametaanalysis AT gregoires recurrentstrokeriskandcerebralmicrobleedburdeninischemicstrokeandtiaametaanalysis AT raysonp recurrentstrokeriskandcerebralmicrobleedburdeninischemicstrokeandtiaametaanalysis AT imaizumit recurrentstrokeriskandcerebralmicrobleedburdeninischemicstrokeandtiaametaanalysis AT flurif recurrentstrokeriskandcerebralmicrobleedburdeninischemicstrokeandtiaametaanalysis AT nakah recurrentstrokeriskandcerebralmicrobleedburdeninischemicstrokeandtiaametaanalysis AT horstmanns recurrentstrokeriskandcerebralmicrobleedburdeninischemicstrokeandtiaametaanalysis AT veltkampr recurrentstrokeriskandcerebralmicrobleedburdeninischemicstrokeandtiaametaanalysis AT rothwellp recurrentstrokeriskandcerebralmicrobleedburdeninischemicstrokeandtiaametaanalysis AT kwav recurrentstrokeriskandcerebralmicrobleedburdeninischemicstrokeandtiaametaanalysis AT thijsv recurrentstrokeriskandcerebralmicrobleedburdeninischemicstrokeandtiaametaanalysis AT leey recurrentstrokeriskandcerebralmicrobleedburdeninischemicstrokeandtiaametaanalysis AT kimy recurrentstrokeriskandcerebralmicrobleedburdeninischemicstrokeandtiaametaanalysis AT huangy recurrentstrokeriskandcerebralmicrobleedburdeninischemicstrokeandtiaametaanalysis AT wongk recurrentstrokeriskandcerebralmicrobleedburdeninischemicstrokeandtiaametaanalysis AT jagerh recurrentstrokeriskandcerebralmicrobleedburdeninischemicstrokeandtiaametaanalysis AT werringd recurrentstrokeriskandcerebralmicrobleedburdeninischemicstrokeandtiaametaanalysis |