医学
红细胞压积
腔隙性中风
冲程(发动机)
内科学
半影
心脏病学
人口
队列
隐蔽的
缺血性中风
缺血
哲学
工程类
环境卫生
机械工程
语言学
作者
David Roh,Ricardo Murguia-Fuentes,Kursat Gurel,Farid Khasiyev,Salwa Rahman,Pedro Bueno,Khrystyna Kozii,Antonio Spagnolo‐Allende,Azzurra Cottarelli,Marialaura Simonetto,Robin Ji,Jia Guo,Vadim Spektor,Eldad A. Hod,Devin Burke,Elisa Konofagou,Tatjana Rundek,Clinton B. Wright,Randolph S. Marshall,Mitchell S.V. Elkind,José Gutierrez
出处
期刊:Neurology
[Ovid Technologies (Wolters Kluwer)]
日期:2023-12-19
卷期号:102 (2)
被引量:1
标识
DOI:10.1212/wnl.0000000000207961
摘要
Background and Objectives Red blood cell (RBC) concentrations are known to associate with ischemic stroke. It is unclear whether RBC concentrations associate specifically with small vessel disease lacunar infarcts. We investigated the hypothesis that RBC concentrations associate with both chronic covert and acute symptomatic brain MRI lacunar infarcts. Methods A cross-sectional observational analysis was performed across 2 cohorts with available hematocrit (as the assessment of RBC concentration exposure) and MRI outcome data. The primary setting was a population-based cohort of stroke-free, older adult (>50 years) participants from the Northern Manhattan Study (NOMAS) enrolled between 2003 and 2009. A second replication sample consisted of patients admitted with acute stroke and enrolled into the Columbia Stroke Registry (CSR) between 2005 and 2020. Associations of hematocrit with (1) chronic, covert lacunar infarcts and (2) symptomatic (i.e., acute) lacunar strokes were separately assessed from the NOMAS and CSR cohorts, respectively, using general additive models after adjusting for relevant covariates. Results Of 1,218 NOMAS participants analyzed, 6% had chronic, covert lacunar infarcts. The association between hematocrit and these covert lacunar infarcts was U-shaped (χ 2 = 9.21 for nonlinear associations; p = 0.03), with people with hematocrit extremes being more likely to have covert lacunar infarcts. Of the 1,489 CSR patients analyzed, 23% had acute lacunar strokes. In this sample, only the relationships of increased hematocrit concentrations and lacunar strokes were replicated (adjusted coefficient β = 0.020; SE = 0.009; p = 0.03). Discussion We identified relationships of hematocrit with MRI lacunar infarcts in both stroke-free and ischemic stroke cohorts, respectively. The relationship between increased hematocrit concentrations with lacunar infarcts was replicated in both cohorts. Further studies are required to clarify the mechanisms behind the relationships of hematocrit with ischemic cerebral small vessel disease.
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