Cortical superficial siderosis and recurrent intracerebral hemorrhage risk in cerebral amyloid angiopathy: Large prospective cohort and preliminary meta-analysis

International Journal of Stroke : Official Journal of the International Stroke Society
Andreas CharidimouAnand Viswanathan

Abstract

We aimed to investigate cortical superficial siderosis as an MRI predictor of lobar intracerebral hemorrhage (ICH) recurrence risk in cerebral amyloid angiopathy (CAA), in a large prospective MRI cohort and a systematic review. We analyzed a single-center MRI prospective cohort of consecutive CAA-related ICH survivors. Using Kaplan-Meier and Cox regression analyses, we investigated cortical superficial siderosis and ICH risk, adjusting for known confounders. We pooled data with eligible published cohorts in a two-stage meta-analysis using random effects models. Covariate-adjusted hazard rations (adj-HR) from pre-specified multivariable Cox proportional hazard models were used. The cohort included 240 CAA-ICH survivors (cortical superficial siderosis prevalence: 36%). During a median follow-up of 2.6 years (IQR: 0.9-5.1 years) recurrent ICH occurred in 58 patients (24%). In prespecified multivariable Cox regression models, cortical superficial siderosis presence and disseminated cortical superficial siderosis were independent predictors of increased symptomatic ICH risk at follow-up (HR: 2.26; 95% CI: 1.31-3.87, p = 0.003 and HR: 3.59; 95% CI: 1.96-6.57, p < 0.0001, respectively). Three cohorts including 443 CAA-ICH patients in ...Continue Reading

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Citations

Feb 26, 2021·Current Opinion in Neurology·Maria Clara Zanon ZotinPinar Yilmaz
Feb 25, 2021·Open Medicine·Shan-Chun ZhangWei-Ping Wu
Feb 26, 2021·European Heart Journal. Case Reports·Alexander D HiltMarieke J H Wermer
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Jan 28, 2021·Cerebrovascular Diseases Extra·João PinhoTiago Gil Oliveira
Dec 10, 2021·International Journal of Stroke : Official Journal of the International Stroke Society·Hugh S Markus

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