Total cerebral small vessel disease burden and stroke outcomes in large vessel occlusion stroke receiving endovascular treatment: A systematic review and meta-analysis

Cheng, Xiaofang; Chen, Quanhui; Ren, Qiuxia; Ma, Haoyuan; Zhao, Yan; Jiao, Shusheng

doi:10.1016/j.jocn.2024.04.003

Journal of Clinical Neuroscience

2024

DOI: 10.1016/j.jocn.2024.04.003

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Total cerebral small vessel disease burden and stroke outcomes in large vessel occlusion stroke receiving endovascular treatment: A systematic review and meta-analysis

Xiaofang Cheng,

Quanhui Chen,

Qiuxia Ren

et al.

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2024

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Higher burden of cerebral small vessel disease is associated with risk of incident stroke in community dwelling individuals

Pinheiro,

Aparicio,

Lioutas

et al. 2024

Preprint

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Background: Mild manifestations of individual cerebral small vessel disease (CSVD) markers are common and may not denote increased risk, but high CSVD burden identifies individuals at increased risk of stroke and dementia. Scores incorporating multiple individual CSVD markers may better identify a person's risk. We related a multi-marker CSVD score to risk of incident stroke and compared it with the Framingham Stroke Risk Profile (FSRP) in community-dwelling individuals. Methods: Framingham Heart Study participants aged >55 years, free of stroke and dementia and with brain magnetic resonance imaging ratings of CSVD markers were included. A multi-marker CSVD score reflecting increasing CSVD burden was used, assigning one point each for presence of cerebral microbleeds, severe perivascular spaces, extensive white matter hyperintensities, covert brain infarcts, and cortical superficial siderosis. Multivariable Cox proportional hazards regression analyses were used to relate CSVD score to incident stroke. Results: Among 1,154 participants (46% male, mean age 70.9±8.7), 92 (8%) developed stroke over a median follow-up of 8.6 years (Q1-Q3: 5.1-12.5). In models adjusting for age, sex, time interval between clinic exam and MRI, FHS cohort, and FSRP, those with three or more markers had increased risk of stroke (HR: 2.62; 95% CI: 1.17-5.88). In comparison, a 5-percent increase in FSRP was also associated with increased risk (aHR: 1.16; 95% CI: 1.04-1.29). The FSRP and CSVD score had similar model discrimination metrics. Interpretation: Higher CSVD burden is associated with increased risk of stroke, beyond the effect explained by risk factors in the FSRP. These findings support consideration of CSVD burden to identify risk of stroke in community-dwelling individuals for early implementation of preventive strategies.

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Higher burden of cerebral small vessel disease is associated with risk of incident stroke in community dwelling individuals

Pinheiro,

Aparicio,

Lioutas

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

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Total cerebral small vessel disease burden and stroke outcomes in large vessel occlusion stroke receiving endovascular treatment: A systematic review and meta-analysis

Cited by 1 publication

References 32 publications

Higher burden of cerebral small vessel disease is associated with risk of incident stroke in community dwelling individuals

Higher burden of cerebral small vessel disease is associated with risk of incident stroke in community dwelling individuals

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