Risk of recurrent stroke in patients with silent brain infarction in the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) imaging substudy

Ralph Weber, Christian Weimar, Isabel Wanke, Claudia Möller-Hartmann, Elke R. Gizewski, Jon Blatchford, Karin Hermansson, Andrew M. Demchuk, Michael Forsting, Ralph L. Sacco, Jeffrey L. Saver, Steven Warach, Hans Christoph Diener, Anke Diehl

Research output: Contribution to journalArticle

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Abstract

Background and Purpose-: Silent brain infarctions are associated with an increased risk of stroke in healthy individuals. Risk of recurrent stroke in patients with both symptomatic and silent brain infarction (SBI) has only been investigated in patients with cardioembolic stroke in the European Atrial Fibrillation Trial. We assessed whether patients with recent noncardioembolic stroke and SBI detected on MRI are at increased risk for recurrent stroke, other cardiovascular events, and mortality. Methods-: The prevalence of SBI detected on MRI was assessed in 1014 patients enrolled in the imaging substudy of the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial. The primary outcome was first recurrence of stroke in patients with both symptomatic stroke and SBI in comparison with age-and sex-matched patients with stroke without SBI. Secondary outcomes were a combined vascular end point, other vascular events, and mortality. The 2 groups were compared using conditional logistic regression. Results-: Silent brain infarction was detected in 207 (20.4%) of the 1014 patients. Twenty-seven (13.0%) patients with SBI and 19 (9.2%) without SBI had a recurrent stroke (OR, 1.42; 95% CI, 0.79-2.56; P=0.24) during a mean follow-up of 2.5 years. Similarly, there was no statistically significant difference for all secondary outcome parameters between patients with SBI and matched patients without SBI. Conclusions-: The presence of SBI in patients with recent mild noncardioembolic ischemic stroke could not be shown to be an independent risk factor for recurrent stroke, other vascular events, or a higher mortality rate. Clinical Trial Registration-: URL: http:// clinicaltrials.gov. Unique identifier: NCT00153062.

Original languageEnglish (US)
Pages (from-to)350-355
Number of pages6
JournalStroke
Volume43
Issue number2
DOIs
StatePublished - Feb 2012

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Brain Infarction
Stroke
Blood Vessels
Mortality
Atrial Fibrillation

Keywords

  • cerebral infarction
  • ischemic stroke
  • magnetic resonance imaging
  • mortality
  • silent brain infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

Risk of recurrent stroke in patients with silent brain infarction in the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) imaging substudy. / Weber, Ralph; Weimar, Christian; Wanke, Isabel; Möller-Hartmann, Claudia; Gizewski, Elke R.; Blatchford, Jon; Hermansson, Karin; Demchuk, Andrew M.; Forsting, Michael; Sacco, Ralph L.; Saver, Jeffrey L.; Warach, Steven; Diener, Hans Christoph; Diehl, Anke.

In: Stroke, Vol. 43, No. 2, 02.2012, p. 350-355.

Research output: Contribution to journalArticle

Weber, R, Weimar, C, Wanke, I, Möller-Hartmann, C, Gizewski, ER, Blatchford, J, Hermansson, K, Demchuk, AM, Forsting, M, Sacco, RL, Saver, JL, Warach, S, Diener, HC & Diehl, A 2012, 'Risk of recurrent stroke in patients with silent brain infarction in the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) imaging substudy', Stroke, vol. 43, no. 2, pp. 350-355. https://doi.org/10.1161/STROKEAHA.111.631739
Weber, Ralph ; Weimar, Christian ; Wanke, Isabel ; Möller-Hartmann, Claudia ; Gizewski, Elke R. ; Blatchford, Jon ; Hermansson, Karin ; Demchuk, Andrew M. ; Forsting, Michael ; Sacco, Ralph L. ; Saver, Jeffrey L. ; Warach, Steven ; Diener, Hans Christoph ; Diehl, Anke. / Risk of recurrent stroke in patients with silent brain infarction in the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) imaging substudy. In: Stroke. 2012 ; Vol. 43, No. 2. pp. 350-355.
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abstract = "Background and Purpose-: Silent brain infarctions are associated with an increased risk of stroke in healthy individuals. Risk of recurrent stroke in patients with both symptomatic and silent brain infarction (SBI) has only been investigated in patients with cardioembolic stroke in the European Atrial Fibrillation Trial. We assessed whether patients with recent noncardioembolic stroke and SBI detected on MRI are at increased risk for recurrent stroke, other cardiovascular events, and mortality. Methods-: The prevalence of SBI detected on MRI was assessed in 1014 patients enrolled in the imaging substudy of the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial. The primary outcome was first recurrence of stroke in patients with both symptomatic stroke and SBI in comparison with age-and sex-matched patients with stroke without SBI. Secondary outcomes were a combined vascular end point, other vascular events, and mortality. The 2 groups were compared using conditional logistic regression. Results-: Silent brain infarction was detected in 207 (20.4{\%}) of the 1014 patients. Twenty-seven (13.0{\%}) patients with SBI and 19 (9.2{\%}) without SBI had a recurrent stroke (OR, 1.42; 95{\%} CI, 0.79-2.56; P=0.24) during a mean follow-up of 2.5 years. Similarly, there was no statistically significant difference for all secondary outcome parameters between patients with SBI and matched patients without SBI. Conclusions-: The presence of SBI in patients with recent mild noncardioembolic ischemic stroke could not be shown to be an independent risk factor for recurrent stroke, other vascular events, or a higher mortality rate. Clinical Trial Registration-: URL: http:// clinicaltrials.gov. Unique identifier: NCT00153062.",
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AU - Weber, Ralph

AU - Weimar, Christian

AU - Wanke, Isabel

AU - Möller-Hartmann, Claudia

AU - Gizewski, Elke R.

AU - Blatchford, Jon

AU - Hermansson, Karin

AU - Demchuk, Andrew M.

AU - Forsting, Michael

AU - Sacco, Ralph L.

AU - Saver, Jeffrey L.

AU - Warach, Steven

AU - Diener, Hans Christoph

AU - Diehl, Anke

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N2 - Background and Purpose-: Silent brain infarctions are associated with an increased risk of stroke in healthy individuals. Risk of recurrent stroke in patients with both symptomatic and silent brain infarction (SBI) has only been investigated in patients with cardioembolic stroke in the European Atrial Fibrillation Trial. We assessed whether patients with recent noncardioembolic stroke and SBI detected on MRI are at increased risk for recurrent stroke, other cardiovascular events, and mortality. Methods-: The prevalence of SBI detected on MRI was assessed in 1014 patients enrolled in the imaging substudy of the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial. The primary outcome was first recurrence of stroke in patients with both symptomatic stroke and SBI in comparison with age-and sex-matched patients with stroke without SBI. Secondary outcomes were a combined vascular end point, other vascular events, and mortality. The 2 groups were compared using conditional logistic regression. Results-: Silent brain infarction was detected in 207 (20.4%) of the 1014 patients. Twenty-seven (13.0%) patients with SBI and 19 (9.2%) without SBI had a recurrent stroke (OR, 1.42; 95% CI, 0.79-2.56; P=0.24) during a mean follow-up of 2.5 years. Similarly, there was no statistically significant difference for all secondary outcome parameters between patients with SBI and matched patients without SBI. Conclusions-: The presence of SBI in patients with recent mild noncardioembolic ischemic stroke could not be shown to be an independent risk factor for recurrent stroke, other vascular events, or a higher mortality rate. Clinical Trial Registration-: URL: http:// clinicaltrials.gov. Unique identifier: NCT00153062.

AB - Background and Purpose-: Silent brain infarctions are associated with an increased risk of stroke in healthy individuals. Risk of recurrent stroke in patients with both symptomatic and silent brain infarction (SBI) has only been investigated in patients with cardioembolic stroke in the European Atrial Fibrillation Trial. We assessed whether patients with recent noncardioembolic stroke and SBI detected on MRI are at increased risk for recurrent stroke, other cardiovascular events, and mortality. Methods-: The prevalence of SBI detected on MRI was assessed in 1014 patients enrolled in the imaging substudy of the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial. The primary outcome was first recurrence of stroke in patients with both symptomatic stroke and SBI in comparison with age-and sex-matched patients with stroke without SBI. Secondary outcomes were a combined vascular end point, other vascular events, and mortality. The 2 groups were compared using conditional logistic regression. Results-: Silent brain infarction was detected in 207 (20.4%) of the 1014 patients. Twenty-seven (13.0%) patients with SBI and 19 (9.2%) without SBI had a recurrent stroke (OR, 1.42; 95% CI, 0.79-2.56; P=0.24) during a mean follow-up of 2.5 years. Similarly, there was no statistically significant difference for all secondary outcome parameters between patients with SBI and matched patients without SBI. Conclusions-: The presence of SBI in patients with recent mild noncardioembolic ischemic stroke could not be shown to be an independent risk factor for recurrent stroke, other vascular events, or a higher mortality rate. Clinical Trial Registration-: URL: http:// clinicaltrials.gov. Unique identifier: NCT00153062.

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