Age related white matter changes predict stroke death in long term follow-up

Oksala, Niku; Oksala, Anni; Pohjasvaara, Tarja; Vataja, Risto; Kaste, Markku; Karhunen, Pekka J.; Erkinjuntti, Timo

doi:10.1136/jnnp.2008.154104

Cited by 49 publications

(53 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous findings on the association of calculated creatinine clearance, creatinine level, high urea or ratio of urea to creatinine, and eGFR with long-term survival in patients hospitalized for acute stroke [2][3][4][5] are in line with our findings. Using the same cohort, we have previously demonstrated the effect of WMLs 21 and cognitive status 36 on long-term survival after acute stroke. Interestingly, cognitive function, kidney function, and WMLs have been shown to be closely associated with each other, 6,14,15 most probably due to coexisting cerebral and glomerular small vessel disease.…”

Section: Discussionmentioning

confidence: 99%

“…First, cerebral small vessel disease is reflected by WMLs 16,32 and WMLs are directly related with risk of recurrent strokes 17,18,[33][34][35] and poor survival mostly due to cardiovascular causes. [17][18][19]21 Second, the association of WMLs and glomerular small vessel disease has been demonstrated in several different stages of kidney disease involving predialysis patients and patients with end-stage kidney disease. 6,7,[11][12][13] Third, metabolic alterations and disturbances in cerebral blood flow have been demonstrated to be associated with degree of renal function.…”

Section: Discussionmentioning

confidence: 99%

“…20 In addition, severe WMLs predict long-term survival in patients with acute stroke. 21 Previous studies addressing the effect of renal function on survival of patients with acute stroke did not report data on WMLs. [2][3][4][5] The intimate association of glomerular and cerebral small vessel disease has been subject to considerable debate.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Cerebral Small Vessel Disease and Kidney Function Predict Long-Term Survival in Patients With Acute Stroke

Oksala

Salonen

Strandberg³

et al. 2010

Stroke

View full text Add to dashboard Cite

Background and Purpose-Cerebral small vessel disease reflected by white matter lesions (WMLs) in MRI and kidney function reflected by estimated glomerular filtration rate (eGFR) is closely associated in patients without stroke. We studied whether eGFR and WMLs predict long-term survival in patients with acute stroke. Methods-After exclusion of patients with low eGFR (Nϭ5 [1.3%]; Ͻ30 mL/min/1.73 m 2 ), consecutive patients with acute stroke (Nϭ378) subjected to MRI and serum creatinine determination were included in the study and prospectively followed-up up to 12 years. Results-Of the patients, 71.2% had died during the follow-up, 152 (40.2%) had moderate (eGFR Ͻ60 mL/min/1.73 m

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cerebral Small Vessel Disease and Kidney Function Predict Long-Term Survival in Patients With Acute Stroke

Oksala

Salonen

Strandberg³

et al. 2010

Stroke

View full text Add to dashboard Cite

show abstract

“…15 The association of known risk factors (age, sex, atrial fibrillation, hypertension, diabetes mellitus, smoking status, and low education) with moderate-to-severe WMLs on MRI was analyzed using a binary multivariable model with forced entry.…”

Section: Data Analysis and Statisticsmentioning

confidence: 99%

White Matter Lesions Are Associated With Hospital Admissions Because of Hip-Fractures and Trauma After Ischemic Stroke

Sibolt

Curtze

Melkas

et al. 2014

Stroke

View full text Add to dashboard Cite

The Helsinki Stroke Aging Memory (SAM) cohort consists of 1622 consecutive patients with suspected stroke (all Finnish, white) admitted to the Helsinki University Central Hospital between December 1, 1993 and March 30, 1995. Patients without ischemic stroke (n=175), intracerebral (n=229), or subarachnoid (n=69) hemorrhage were Background and Purpose-Cerebral white matter lesions (WMLs), a surrogate for cerebral small-vessel disease, have been shown to be associated with decreasing mobility, gait instability, and falls. The aim of this study was to investigate whether WMLs of the brain are associated with increased incidence of hospital admissions because of any trauma and hip-fractures in a cohort of patients with stroke. Methods-We included 383 consecutive patients aged 55 to 85 years with ischemic stroke admitted to the Helsinki University Central Hospital (The Stroke Aging Memory cohort) with a 12-year follow-up. National register data were reviewed for hip-fractures, other traumatic injuries, survival data, and causes of death. WMLs were rated using MRI and dichotomized as none to mild and moderate to severe. The data were analyzed using Kaplan-Meier plots (log-rank) and a complex Cox multivariable hazards models for multiple cases per subject to assess hazard ratios with their 95% confidence intervals. Results-During the 12-year follow-up, there were more hip-fractures (13.5% versus 6.5%; log-rank, P=0.01) and more hospital admissions because of traumatic injury (22.2% versus 16.7%; log-rank, P=0.04) in the moderate-to-severe than in the none-to-mild WMLs group. In the complex samples, Cox multivariable model adjusting for age, sex, National

show abstract

“…7 Outros estudos identificaram uma associação entre a presença de lesões da substância branca extensas e um aumento da mortalidade. 8 As alterações da substância branca terão provavelmente um substrato fisiopatológico multifactorial. Sendo certo o aumento da proporção da população idosa, a prevalência quase endémica das HSBPEV nessa faixa etária e a sua associação a um acréscimo de comorbilidades e mortalidade, torna-se crucial identificar os factores de risco que contribuem para o seu desenvolvimento, afim de ser possível desenvolver acções de prevenção primárias e/ ou secundárias.…”

Section: Introductionunclassified

Aterosclerose Carotídea e Hipodensidades da Substância Branca: uma Relação Controversa

et al. 2014

View full text Add to dashboard Cite

Introduction:White matter hypodensities of presumed vascular origin, are recognized as an important cause of morbidity with established clinical and cognitive consequences. Nonetheless, many doubts remain on its physiopathology. Our goal is to clarify the potential role of carotid atherosclerosis and other vascular risk factors in the development of white matter hypodensities of presumed vascular origin. Material and Methods:We included patients that underwent CT brain scan and neurosonologic evaluation within a one-month period. Full assessment of vascular risks factors was performed. We seek to find independent associations between white matter hypodensities of presumed vascular origin, carotid intima-media thickness and vascular risk factors. Results: 472 patients were included, mean age was 67.32 (SD: 14.75), 274 (58.1%) were male. The independent predictors of white matter hypodensities of presumed vascular origin were age (OR: 1.067, 95% IC: 1.049 -1.086, p < 0.001) and hypertension (OR: 1.726, 95% IC: 1.097 -2.715, p = 0.018). No association was found between IMT (OR: 2.613, 95% IC: 0.886 -7.708, p = 0.082) or carotid artery stenosis (OR: 1.021, 95% IC: 0.785 -1.328, p = 0.877) and white matter hypodensities of presumed vascular origin. Discussion: Only age and hypertension proved to have an independent association with white matter hypodensities of presumed vascular origin. Carotid atherosclerosis, evaluated by IMT and the degree of carotid artery stenosis, showed no association with white matter hypodensities of presumed vascular origin. Since atherosclerosis is a systemic pathology, these results suggest that alternative mechanisms are responsible for the development of white matter hypodensities of presumed vascular origin. Conclusion: Age and hypertension seem to be the main factors in the development of white matter hypodensities of presumed vascular origin. No association was found between carotid atherosclerosis and white matter hypodensities of presumed vascular origin.

show abstract

Age related white matter changes predict stroke death in long term follow-up

Abstract: In patients with acute stroke, ARWMC seems to be a significant predictor of poor long term survival and death by ischaemic stroke.

Cited by 49 publications

References 30 publications

Cerebral Small Vessel Disease and Kidney Function Predict Long-Term Survival in Patients With Acute Stroke

Cerebral Small Vessel Disease and Kidney Function Predict Long-Term Survival in Patients With Acute Stroke

White Matter Lesions Are Associated With Hospital Admissions Because of Hip-Fractures and Trauma After Ischemic Stroke

Aterosclerose Carotídea e Hipodensidades da Substância Branca: uma Relação Controversa

Contact Info

Product

Resources

About