1. Silent Cerebral Infarction is Associated with Incident Stroke and TIA Independent of Carotid Intima-Media Thickness
- Author
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Kazuo Kitagawa, Shigetaka Furukado, Saburo Sakoda, Kaori Miwa, Makiko Tanaka, Hidetaka Hougaku, Manabu Sakaguchi, Shuhei Okazaki, Taku Hoshi, and Yuko Abe
- Subjects
Male ,Tunica media ,medicine.medical_specialty ,Comorbidity ,Kaplan-Meier Estimate ,Risk Assessment ,Severity of Illness Index ,Cohort Studies ,Age Distribution ,Predictive Value of Tests ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Carotid Stenosis ,Prospective Studies ,cardiovascular diseases ,Sex Distribution ,Prospective cohort study ,Stroke ,Aged ,business.industry ,Cerebral infarction ,Proportional hazards model ,Incidence ,Cerebral Infarction ,General Medicine ,Middle Aged ,medicine.disease ,Survival Analysis ,Surgery ,Radiography ,medicine.anatomical_structure ,Intima-media thickness ,Ischemic Attack, Transient ,Predictive value of tests ,Disease Progression ,cardiovascular system ,Cardiology ,Female ,Tunica Media ,business ,Magnetic Resonance Angiography ,Follow-Up Studies ,Cohort study - Abstract
Background Both silent cerebral infarction (SCI) and carotid intima-media thickness (IMT) are associated with future stroke. We evaluated whether SCI could be a predictor for incident stroke independent of carotid IMT in high-risk patients. Methods We performed a prospective cohort study among 282 outpatients who had one or more atherosclerotic risk factors but without a history of cardiovascular disease. We conducted cranial MRI and measured carotid IMT at baseline, and then evaluated the risks of incident stroke and transient ischemic attacks (TIA) using Cox proportional hazards models. Results SCI was present in 67 patients (23.7%) at baseline. During 4.1 years of follow-up, stroke and TIA occurred in 8 patients (2.8%). The incidence of stroke/TIA was 22.3 per 1,000 person-years in those with SCI compared with 2.2 per 1,000 person-years in those without SCI. Both SCI and carotid IMT at baseline were associated with incident stroke/TIA events after adjustment for age, sex, and traditional vascular risk factors. The predictive value of SCI remained significant even after adjustment for carotid IMT (HR 8.56; 1.72-42.55). Conclusion SCI, similar to carotid IMT, is an independent predictor of stroke and TIA in high-risk patients.
- Published
- 2010