Association of white matter hyperintensities with long-term stroke recurrence in patients with recent subcortical small infarcts
10.3760/cma.j.issn.1673-4165.2024.01.003
- VernacularTitle:脑白质高信号与近期皮质下小梗死患者远期卒中复发的相关性
- Author:
Xiaohui MU
1
;
Fei WANG
;
Tingting LIU
;
Shugang CAO
;
Mingwu XIA
;
Rongfeng WANG
Author Information
1. 蚌埠医学院附属合肥市第二人民医院神经内科，合肥 230011
- Keywords:
Cerebral small vessel diseases;
Cerebral infarction;
White matter;
Stroke;
Recurrence;
Magnetic resonance imaging;
Risk factors
- From:
International Journal of Cerebrovascular Diseases
2024;32(1):15-21
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the association of white matter hyperintensities (WMHs) with long-term stroke recurrence in patients with recent subcortical small infarcts (RSSIs).Methods:Consecutive patients admitted to the Department of Neurology, Hefei Hospital Affiliated to Anhui Medical University between January 2019 and August 2022 and met the clinical and imaging manifestations of RSSIs were collected. The demographic characteristics, baseline clinical data, and MRI features were collected. Using stroke recurrence as the endpoint event, the recurrence time was recorded, and Cox regression model was used to analyze relevant factors affecting stroke recurrence in patients with RSSIs.Results:A total of 202 patients were enrolled, including 138 males (68.3%), aged 67.9±10.5 years. Seventy-seven patients (38.1%) were mild WMHs, 64 (31.7%) were moderate WMHs, and 61 (30.2%) were severe WMHs. There were statistically significant differences in age, history of stroke, hypertension, hyperlipidemia, total cholesterol, infarct thickness, and infarct distribution among different WMHs severity groups (all P<0.05). The median follow-up time was 40.5 months (interquartile range, 27.7-49.0 months), and a total of 55 patients (27.2%) had stroke recurrence (ischemic stroke 54, occipital hemorrhage 1). Recurrence rates of stroke in the mild, moderate, and severe WMHs groups were 18.2%, 31.3%, and 34.4%, respectively. Cox regression analysis showed that WMHs were an independent risk factor for stroke recurrence (compared to the mild group, the risk ratio of the severe group was 2.225, 95% confidence interval was 1.116-4.436; P=0.023). Conclusion:The risk of long-term stroke recurrence in patients with RSSI is associated with the severity of WMHs.
