Clinical Features of a First-Ever Lacunar Infarction in Japanese Patients: Poor Outcome in Females

Saji, Naoki; Shimizu, Hirotaka; Kawarai, Toshitaka; Tadano, Makoto; Kita, Yasushi; Yokono, Koichi

doi:10.1016/j.jstrokecerebrovasdis.2009.12.005

Cited by 18 publications

(24 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[17][18][19][22][23][24] Common covariates included age, stroke severity, and comorbidities. There were 6 comparisons rendered nonsignificant by adjustment for covariates, 15,16,20,21,25 which were most commonly age, stroke severity, comorbidities, and health behaviors.…”

Section: Activity Limitationsmentioning

confidence: 99%

Focused Update of Sex Differences in Patient Reported Outcome Measures After Stroke

Gall

Phan

Madsen

et al. 2018

Stroke

View full text Add to dashboard Cite

W omen experience worse outcomes after stroke than men 1 despite their lower age-adjusted incidence of stroke.2 Previous reviews of sex differences in select stroke outcomes, including activity limitations, 3-5 participation restriction, 4 poststroke depression (PSD), 3 and health-related quality of life (HRQoL), 3,4 demonstrated that women had worse outcomes than men across many of these measures. Women's greater age and stroke severity, as well as poorer prestroke function, seem to contribute to the sex difference in outcomes, but data on other contributing factors are limited.4 Existing reviews included studies published >5 years ago, and given the rapid increase in the number of studies addressing sex differences in stroke outcomes, an updated review is warranted. MethodsFull details of our methods are provided in the online-only Data Supplement. A previous review included studies up to 2007, 3 so we reviewed studies from 2007 onwards that examined sex differences in patient reported outcome measures (PROMs) at ≤12 months after stroke, including activity limitations, HRQoL, participation restriction, impaired cognition, and mood. 6 Full results tables are shown in the online-only Data Supplement. Results Activity LimitationsOf 1875 articles identified, 22 studies (3 population based) that were designed to examine sex differences (Results and Table I in the online-only Data Supplement) met criteria for inclusion. The most common instrument to assess activity limitations was the modified Rankin Scale, followed by the Barthel Index.In 8 studies including ischemic and hemorrhagic strokes, unadjusted estimates showed that women had more activity limitations than men through significantly lower odds of good outcome (odds ratio [OR] range: 0.44-0.61) 7-9 or greater odds of poor outcome (OR range: 1.29-1.62).10-14 In multivariable adjusted analyses, women had worse outcome than men with significantly lower odds of good outcome (OR range: 0.37-0.75) or greater odds of poor outcome (OR range: 1.17-1.74). 7,8,10,12,13 In 2 studies, there was no statistically significant difference between women and men.11,14 Adjustment for covariates, most commonly age, stroke severity, comorbidities, and prestroke function, reduced the associations between 9% and 20%, suggesting these factors partly explain the greater activity limitations for women after stroke.In 11 studies of ischemic stroke ( Table I in the online-only Data Supplement), women generally had worse outcome than men demonstrated by greater odds of poor outcome (mostly modified Rankin Scale ≥3 versus <3; range in ORs: 1.13-2.40) or lower odds of good outcome (eg, modified Rankin Scale ≤1 versus >1 or independent walking).15-25 Among 13 multivariable adjusted comparisons between men and women (some studies had >1 comparison), women's significantly worse outcome compared with men persisted in 7 comparisons with a greater odds of poor outcome (range, 1.30-3.40) or a higher activities of daily living score. [17][18][19][22][23][24] Common covariates included age, stro...

show abstract

Section: Activity Limitationsmentioning

confidence: 99%

Focused Update of Sex Differences in Patient Reported Outcome Measures After Stroke

Gall

Phan

Madsen

et al. 2018

Stroke

View full text Add to dashboard Cite

show abstract

“…Image acquisition parameters for MRI were as described previously. 4,7,14 SBI was defined as a focal lesion of at least 3 mm in diameter, with hyperintensity on T2WI and hypointensity on FLAIR. [5][6][7]14 WMHs were defined as an irregular periventricular hyperintensity (Fazekas grade X3) and/ or early confluent or confluent separate deep white-matter hyperintense lesions (Fazekas grade X2) on T2WI and FLAIR, based on the rating scales of ischemic tissue damage due to arteriosclerosis.…”

Section: Mri Assessmentmentioning

confidence: 99%

“…Since stroke is a major public health problem, assessment of the risk of stroke is especially important. 4,7 Assessing CAVI may be reasonable, convenient and cost effective as an initial assessment tool to identify SVD, and also baPWV.…”

Section: Arterial Stiffness and Silent Brain Infarct N Saji Et Almentioning

confidence: 99%

Silent brain infarct is independently associated with arterial stiffness indicated by cardio-ankle vascular index (CAVI)

et al. 2012

Self Cite

View full text Add to dashboard Cite

It is still unclear whether silent brain infarct (SBI) and white-matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) scans are associated with cardio-ankle vascular index (CAVI), a novel parameter of arterial stiffness. We studied 220 consecutive patients (mean age, 69 years) without a history of stroke or transient ischemic attack. Patients were assessed for the presence of SBI, WMHs and risk factors. Arterial stiffness was evaluated using CAVI. Patients were categorized into one of two groups according to the presence or absence of SBI and WMHs, and clinical characteristics were compared between the two groups. CAVI was significantly higher in patients with SBI or in patients with WMHs than in those without those respective findings. The CAVI cutoff values for detection of SBI and WMHs were 9.2 and 8.9, respectively. On multivariable analyses, CAVI, a one point increase in CAVI: odds ratio (OR), 1.25; 95% confidence interval (CI), 1.01-1.56; CAVIX9.2: OR, 2.34; 95% CI, 1.16-5.02, was independently associated with SBI, however, CAVI was not independently associated with WMHs. Patients with CAVI X9.2 had higher OR for the presence of both SBI and WMHs (OR, 2.57; 95% CI, 1.15-5.98) when compared with patients with CAVI o9.2 after adjustment for age and sex. SBI is independently associated with arterial stiffness indicated by CAVI.

show abstract

“…The image acquisition parameters were as described previously (1,5). SBI was defined as a focal lesion of at least 3 mm in diameter, with hyperintensity on T2WI and hypointensity on FLAIR (5,9,12).…”

Section: Mri Assessmentmentioning

confidence: 99%

“…Silent brain infarct (SBI) and white matter hyperintensities (WMHs) are risk factors for stroke, and are associated with cognitive impairment and poor functional outcome after stroke (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). The etiology of SBI and WMHs is related to cerebral small vessel disease (SVD) associated with arterial stiffness including age and hypertension (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Association between Silent Brain Infarct and Arterial Stiffness Indicated by Brachial-ankle Pulse Wave Velocity

et al. 2012

Self Cite

View full text Add to dashboard Cite

Objective The aim of this hospital-based cohort study was to clarify the independent association between silent brain infarct (SBI) and arterial stiffness indicated by brachial-ankle pulse wave velocity (baPWV) including the cutoff value for SBI. Methods We studied 240 consecutive patients (mean age 69 years) with no history of stroke. We assessed the presence of SBI, white matter hyperintensities (WMHs), and risk factors. Arterial stiffness was evaluated using baPWV. We measured the intima-media thickness of the common carotid artery (CCAIMT) using carotid ultrasonography. We divided patients into two groups according to the presence or absence of SBI, and compared clinical characteristics between the two groups.

show abstract

Clinical Features of a First-Ever Lacunar Infarction in Japanese Patients: Poor Outcome in Females

Cited by 18 publications

References 25 publications

Focused Update of Sex Differences in Patient Reported Outcome Measures After Stroke

Focused Update of Sex Differences in Patient Reported Outcome Measures After Stroke

Silent brain infarct is independently associated with arterial stiffness indicated by cardio-ankle vascular index (CAVI)

Association between Silent Brain Infarct and Arterial Stiffness Indicated by Brachial-ankle Pulse Wave Velocity

Contact Info

Product

Resources

About