Document Detail


Risk of recurrent stroke in patients with silent brain infarction in the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) imaging substudy.
MedLine Citation:
PMID:  22267825     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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;
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2012-01-19
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  43     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-24     Completed Date:  2012-08-15     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  350-5     Citation Subset:  IM    
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00153062
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiotensin II Type 1 Receptor Blockers / therapeutic use
Aspirin / therapeutic use
Benzimidazoles / therapeutic use
Benzoates / therapeutic use
Brain Ischemia / complications,  pathology
Cerebral Infarction / complications*,  pathology
Dipyridamole / therapeutic use
Female
Humans
Intracranial Embolism / complications,  epidemiology,  pathology
Kaplan-Meier Estimate
Magnetic Resonance Imaging
Male
Middle Aged
Platelet Aggregation Inhibitors / therapeutic use
Recurrence / prevention & control
Risk Factors
Socioeconomic Factors
Stroke / drug therapy,  pathology,  prevention & control*
Ticlopidine / analogs & derivatives,  therapeutic use
Tomography, X-Ray Computed
Treatment Outcome
Vasodilator Agents / therapeutic use
Grant Support
ID/Acronym/Agency:
ZIA NS003044-04/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Benzimidazoles; 0/Benzoates; 0/Platelet Aggregation Inhibitors; 0/Vasodilator Agents; 64ALC7F90C/Dipyridamole; A74586SNO7/clopidogrel; OM90ZUW7M1/Ticlopidine; R16CO5Y76E/Aspirin; U5SYW473RQ/telmisartan
Investigator
Investigator/Affiliation:
Conrado Estol / ; Miguel Garrote / ; María Esnaola y Rojas / ; Sebastián Ameriso / ; Raúl Rey / ; Pablo Leonardo Ioli / ; Juan José Cirio / ; Gustavo Angel Saredo / ; Christopher Bladin / ; Stephen Davis / ; David Howse / ; James Scott / ; Jaime Silva / ; Xiaojiang Sun / ; Ling Miao / ; Wei Li / ; Liying Cui / ; Haibo Chen / ; Weiwei Zhang / ; Lijuan Wang / ; En Xu / ; Qing Di / ; Yan Liu / ; Jörg Glahn / ; Dietmar Schneider / ; Peter Ringleb / ; Wolfgang Steinke / ; Lutz Harms / ; Andreas Hetzel / ; Michael Rosenkranz / ; Carlos Cantu / ; Jorge Villarreal / ; Byung Woo Yoon / ; Byung Chul Lee / ; Ki Hyun Cho / ; Ji Hoe Heo / ; Joung Ho Rha / ; Hyo Suk Nam / ; Sun Uck Kwon / ; Sien-Tsong Chen / ; Jiann-Shing Jeng / ; Helen L Po / ; Ming-Hong Chang / ; Ku-Chou Chang / ; Li-Ming Lien / ; Chung Y Hsu / ; Clinton Wright / ; Daniel Hanley / ; Jeffery Kramer / ; Donald Tamulonis / ; Joseph Weissman / ; Bret Haake / ; Steve Moon / ; Scott Silliman / ; Pierre Fayad / ; Erfan Albakri /
Comments/Corrections

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