Racial differences in microbleed prevalence in primary intracerebral hemorrhage

B. R. Copenhaver, A. W. Hsia, J. G. Merino, R. E. Burgess, J. T. Fifi, L. Davis, S. Warach, C. S. Kidwell

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Primary intracerebral hemorrhage is two to three times more common in many racial populations, including black patients. Previous studies have shown that microbleeds, identified on gradient echo MRI (GRE), are present in 50-80% of patients with primary ICH. The objective of this study was to compare, by race, the rates, risk factors, and topography of microbleeds in patients hospitalized for primary ICH. METHODS: Patients diagnosed with primary ICH at two metropolitan stroke centers were included. Clinical and neuroimaging data were recorded for each patient. Analyses were performed to compare baseline characteristics as well as imaging findings by race. RESULTS: A total of 87 patients met inclusion criteria (42 black subjects, 45 white subjects). The black cohort was younger (p < 0.001), and had a greater rate of hypertension (p = 0.001), but not other vascular risk factors. Microbleeds were more prevalent in the black population, with 74% of blacks having one or more microbleeds compared to 42% of whites (p = 0.005). The black population also tended to have a greater frequency of microbleeds in multiple territories than the white population (38% vs 22%, p = 0.106). When adjusting for age, hypertension, and alcohol use, race was an independent predictor of microbleeds (OR 3.308, 95% CI 1.144-9.571, p = 0.027). CONCLUSIONS: These pilot data suggest that significant racial differences exist in the frequency and topography of microbleeds in patients with primary ICH. Microbleeds may be an important emerging imaging biomarker with the potential to provide insights into ICH pathophysiology, prognosis, and disease progression, as well as possible therapeutic strategies, particularly in medically underserved populations.

Original languageEnglish (US)
Pages (from-to)1176-1182
Number of pages7
JournalNeurology
Volume71
Issue number15
DOIs
StatePublished - Oct 7 2008

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Cerebral Hemorrhage
Population
Hypertension
Vulnerable Populations
Neuroimaging
Disease Progression
Biomarkers
Stroke
Alcohols

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Copenhaver, B. R., Hsia, A. W., Merino, J. G., Burgess, R. E., Fifi, J. T., Davis, L., ... Kidwell, C. S. (2008). Racial differences in microbleed prevalence in primary intracerebral hemorrhage. Neurology, 71(15), 1176-1182. https://doi.org/10.1212/01.wnl.0000327524.16575.ca

Racial differences in microbleed prevalence in primary intracerebral hemorrhage. / Copenhaver, B. R.; Hsia, A. W.; Merino, J. G.; Burgess, R. E.; Fifi, J. T.; Davis, L.; Warach, S.; Kidwell, C. S.

In: Neurology, Vol. 71, No. 15, 07.10.2008, p. 1176-1182.

Research output: Contribution to journalArticle

Copenhaver, BR, Hsia, AW, Merino, JG, Burgess, RE, Fifi, JT, Davis, L, Warach, S & Kidwell, CS 2008, 'Racial differences in microbleed prevalence in primary intracerebral hemorrhage', Neurology, vol. 71, no. 15, pp. 1176-1182. https://doi.org/10.1212/01.wnl.0000327524.16575.ca
Copenhaver BR, Hsia AW, Merino JG, Burgess RE, Fifi JT, Davis L et al. Racial differences in microbleed prevalence in primary intracerebral hemorrhage. Neurology. 2008 Oct 7;71(15):1176-1182. https://doi.org/10.1212/01.wnl.0000327524.16575.ca
Copenhaver, B. R. ; Hsia, A. W. ; Merino, J. G. ; Burgess, R. E. ; Fifi, J. T. ; Davis, L. ; Warach, S. ; Kidwell, C. S. / Racial differences in microbleed prevalence in primary intracerebral hemorrhage. In: Neurology. 2008 ; Vol. 71, No. 15. pp. 1176-1182.
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abstract = "BACKGROUND: Primary intracerebral hemorrhage is two to three times more common in many racial populations, including black patients. Previous studies have shown that microbleeds, identified on gradient echo MRI (GRE), are present in 50-80{\%} of patients with primary ICH. The objective of this study was to compare, by race, the rates, risk factors, and topography of microbleeds in patients hospitalized for primary ICH. METHODS: Patients diagnosed with primary ICH at two metropolitan stroke centers were included. Clinical and neuroimaging data were recorded for each patient. Analyses were performed to compare baseline characteristics as well as imaging findings by race. RESULTS: A total of 87 patients met inclusion criteria (42 black subjects, 45 white subjects). The black cohort was younger (p < 0.001), and had a greater rate of hypertension (p = 0.001), but not other vascular risk factors. Microbleeds were more prevalent in the black population, with 74{\%} of blacks having one or more microbleeds compared to 42{\%} of whites (p = 0.005). The black population also tended to have a greater frequency of microbleeds in multiple territories than the white population (38{\%} vs 22{\%}, p = 0.106). When adjusting for age, hypertension, and alcohol use, race was an independent predictor of microbleeds (OR 3.308, 95{\%} CI 1.144-9.571, p = 0.027). CONCLUSIONS: These pilot data suggest that significant racial differences exist in the frequency and topography of microbleeds in patients with primary ICH. Microbleeds may be an important emerging imaging biomarker with the potential to provide insights into ICH pathophysiology, prognosis, and disease progression, as well as possible therapeutic strategies, particularly in medically underserved populations.",
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AU - Copenhaver, B. R.

AU - Hsia, A. W.

AU - Merino, J. G.

AU - Burgess, R. E.

AU - Fifi, J. T.

AU - Davis, L.

AU - Warach, S.

AU - Kidwell, C. S.

PY - 2008/10/7

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N2 - BACKGROUND: Primary intracerebral hemorrhage is two to three times more common in many racial populations, including black patients. Previous studies have shown that microbleeds, identified on gradient echo MRI (GRE), are present in 50-80% of patients with primary ICH. The objective of this study was to compare, by race, the rates, risk factors, and topography of microbleeds in patients hospitalized for primary ICH. METHODS: Patients diagnosed with primary ICH at two metropolitan stroke centers were included. Clinical and neuroimaging data were recorded for each patient. Analyses were performed to compare baseline characteristics as well as imaging findings by race. RESULTS: A total of 87 patients met inclusion criteria (42 black subjects, 45 white subjects). The black cohort was younger (p < 0.001), and had a greater rate of hypertension (p = 0.001), but not other vascular risk factors. Microbleeds were more prevalent in the black population, with 74% of blacks having one or more microbleeds compared to 42% of whites (p = 0.005). The black population also tended to have a greater frequency of microbleeds in multiple territories than the white population (38% vs 22%, p = 0.106). When adjusting for age, hypertension, and alcohol use, race was an independent predictor of microbleeds (OR 3.308, 95% CI 1.144-9.571, p = 0.027). CONCLUSIONS: These pilot data suggest that significant racial differences exist in the frequency and topography of microbleeds in patients with primary ICH. Microbleeds may be an important emerging imaging biomarker with the potential to provide insights into ICH pathophysiology, prognosis, and disease progression, as well as possible therapeutic strategies, particularly in medically underserved populations.

AB - BACKGROUND: Primary intracerebral hemorrhage is two to three times more common in many racial populations, including black patients. Previous studies have shown that microbleeds, identified on gradient echo MRI (GRE), are present in 50-80% of patients with primary ICH. The objective of this study was to compare, by race, the rates, risk factors, and topography of microbleeds in patients hospitalized for primary ICH. METHODS: Patients diagnosed with primary ICH at two metropolitan stroke centers were included. Clinical and neuroimaging data were recorded for each patient. Analyses were performed to compare baseline characteristics as well as imaging findings by race. RESULTS: A total of 87 patients met inclusion criteria (42 black subjects, 45 white subjects). The black cohort was younger (p < 0.001), and had a greater rate of hypertension (p = 0.001), but not other vascular risk factors. Microbleeds were more prevalent in the black population, with 74% of blacks having one or more microbleeds compared to 42% of whites (p = 0.005). The black population also tended to have a greater frequency of microbleeds in multiple territories than the white population (38% vs 22%, p = 0.106). When adjusting for age, hypertension, and alcohol use, race was an independent predictor of microbleeds (OR 3.308, 95% CI 1.144-9.571, p = 0.027). CONCLUSIONS: These pilot data suggest that significant racial differences exist in the frequency and topography of microbleeds in patients with primary ICH. Microbleeds may be an important emerging imaging biomarker with the potential to provide insights into ICH pathophysiology, prognosis, and disease progression, as well as possible therapeutic strategies, particularly in medically underserved populations.

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