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Progression of magnetic resonance imaging-defined brain vascular disease predicts vascular events in elderly: the Cardiovascular Health Study.
Tuesday,2012-11-06 12:25 America/Los_Angeles — eenright
| Title | Progression of magnetic resonance imaging-defined brain vascular disease predicts vascular events in elderly: the Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2011 |
| Authors | Longstreth, WT, Arnold, AM, Kuller, LH, Bernick, C, Lefkowitz, DS, Beauchamp, NJ, Manolio, TA |
| Journal | Stroke |
| Volume | 42 |
| Issue | 10 |
| Pagination | 2970-2 |
| Date Published | 2011 Oct |
| ISSN | 1524-4628 |
| Keywords | Aged, Brain, Disease Progression, Female, Follow-Up Studies, Heart Failure, Humans, Longitudinal Studies, Magnetic Resonance Imaging, Male, Nerve Fibers, Myelinated, Predictive Value of Tests, Prognosis, Stroke |
| Abstract | <p><b>BACKGROUND AND PURPOSE: </b>To determine whether progression of MRI-defined vascular disease predicts subsequent vascular events in the elderly.</p><p><b>METHODS: </b>The Cardiovascular Health Study, a longitudinal cohort study of vascular disease in the elderly, allows us to address this question because its participants had 2 MRI scans≈5 years apart and have been followed for ≈9 years since the follow-up scan for incident vascular events.</p><p><b>RESULTS: </b>Both MRI-defined incident infarcts and worsened white matter grade were significantly associated with heart failure, stroke, and death, but not transient ischemic attacks, angina, or myocardial infarction. Strongest associations occurred when both incident infarcts and worsened white matter grade were present for heart failure (hazard ratio, 1.79; 95% confidence interval, 1.18-2.73), stroke (hazard ratio, 2.58; 95% confidence interval, 1.53-4.36), death (hazard ratio, 1.69; 95% confidence interval, 1.28-2.24), and cardiovascular death (hazard ratio, 1.97; 95% confidence interval, 1.24-3.14).</p><p><b>CONCLUSIONS: </b>Progression of MRI-defined vascular disease identifies elderly people at increased risk for subsequent heart failure, stroke, and death. Whether aggressive risk factor management would reduce risk is unknown.</p> |
| DOI | 10.1161/STROKEAHA.111.622977 |
| Alternate Journal | Stroke |
| PubMed ID | 21817135 |
| PubMed Central ID | PMC3183167 |
| Grant List | N01 HC085086 / HC / NHLBI NIH HHS / United States P30 AG024827 / AG / NIA NIH HHS / United States R01 HL075366 / HL / NHLBI NIH HHS / United States N01 HC085081 / HC / NHLBI NIH HHS / United States R01 AG015928 / AG / NIA NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01 HC075150 / HC / NHLBI NIH HHS / United States HHSN268200800007C / HL / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States R56 AG020098 / AG / NIA NIH HHS / United States P30-AG-024827 / AG / NIA NIH HHS / United States HL-075366 / HL / NHLBI NIH HHS / United States AG-20098 / AG / NIA NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States AG-027058 / AG / NIA NIH HHS / United States N01 HC085080 / HC / NHLBI NIH HHS / United States AG-023269 / AG / NIA NIH HHS / United States N01 HC055222 / HC / NHLBI NIH HHS / United States N01-HC-55222 / HC / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States R01 HL080295 / HL / NHLBI NIH HHS / United States R01 AG020098 / AG / NIA NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States HL080295 / HL / NHLBI NIH HHS / United States N01-HC-85239 / HC / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC085079 / HC / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States R01 AG027058 / AG / NIA NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States R01 AG023629-04 / AG / NIA NIH HHS / United States |