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Separate prediction of intracerebral hemorrhage and ischemic stroke.
Monday,2014-05-05 13:22 America/Los_Angeles — poolea2
| Title | Separate prediction of intracerebral hemorrhage and ischemic stroke. |
| Publication Type | Journal Article |
| Year of Publication | 2014 |
| Authors | Ferket, BS, van Kempen, BJH, Wieberdink, RG, Steyerberg, EW, Koudstaal, PJ, Hofman, A, Shahar, E, Gottesman, RF, Rosamond, W, Kizer, JR, Kronmal, RA, Psaty, BM, Longstreth, WT, Mosley, T, Folsom, AR, Hunink, MGMyriam, Ikram, AM |
| Journal | Neurology |
| Volume | 82 |
| Issue | 20 |
| Pagination | 1804-12 |
| Date Published | 2014 May 20 |
| ISSN | 1526-632X |
| Keywords | Aged, Aged, 80 and over, Atherosclerosis, Body Mass Index, Brain Ischemia, Cholesterol, Female, Humans, Incidence, Intracranial Hemorrhages, Male, Middle Aged, Models, Statistical, Predictive Value of Tests, Risk Assessment, Risk Factors, Stroke |
| Abstract | <p><b>OBJECTIVES: </b>To develop and validate 10-year cumulative incidence functions of intracerebral hemorrhage (ICH) and ischemic stroke (IS).</p><p><b>METHODS: </b>We used data on 27,493 participants from 3 population-based cohort studies: the Atherosclerosis Risk in Communities Study, median age 54 years, 45% male, median follow-up 20.7 years; the Rotterdam Study, median age 68 years, 38% male, median follow-up 14.3 years; and the Cardiovascular Health Study, median age 71 years, 41% male, median follow-up 12.8 years. Among these participants, 325 ICH events, 2,559 IS events, and 9,909 nonstroke deaths occurred. We developed 10-year cumulative incidence functions for ICH and IS using stratified Cox regression and competing risks analysis. Basic models including only established nonlaboratory risk factors were extended with diastolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, body mass index, waist-to-hip ratio, and glomerular filtration rate. The cumulative incidence functions' performances were cross-validated in each cohort separately by Harrell C-statistic and calibration plots.</p><p><b>RESULTS: </b>High total cholesterol/high-density lipoprotein cholesterol ratio decreased the ICH rates but increased IS rates (p for difference across stroke types <0.001). For both the ICH and IS models, C statistics increased more by model extension in the Atherosclerosis Risk in Communities and Cardiovascular Health Study cohorts. Improvements in C statistics were reproduced by cross-validation. Models were well calibrated in all cohorts. Correlations between 10-year ICH and IS risks were moderate in each cohort.</p><p><b>CONCLUSIONS: </b>We developed and cross-validated cumulative incidence functions for separate prediction of 10-year ICH and IS risk. These functions can be useful to further specify an individual's stroke risk.</p> |
| DOI | 10.1212/WNL.0000000000000427 |
| Alternate Journal | Neurology |
| PubMed ID | 24759844 |
| PubMed Central ID | PMC4035707 |
| Grant List | N01HC85080 / HC / NHLBI NIH HHS / United States HHSN268201100005C / / PHS HHS / United States HHSN268201100009C / / PHS HHS / United States HHSN268201100010C / / PHS HHS / United States N01HC85081 / HC / NHLBI NIH HHS / United States N01HC85079 / HC / NHLBI NIH HHS / United States HHSN268201100008C / / PHS HHS / United States HHSN268201100012C / / PHS HHS / United States N01HC85086 / HC / NHLBI NIH HHS / United States N01HC85082 / HC / NHLBI NIH HHS / United States HHSN268201100007C / / PHS HHS / United States HHSN268200800007C / / PHS HHS / United States HHSN268201100011C / / PHS HHS / United States HHSN268201200036C / / PHS HHS / United States HL080295 / HL / NHLBI NIH HHS / United States N01HC85083 / HC / NHLBI NIH HHS / United States HHSN268201100006C / / PHS HHS / United States AG023629 / AG / NIA NIH HHS / United States N01 HC55222 / HC / NHLBI NIH HHS / United States |