Predictors of clinical or cerebral lesion progression in adult moyamoya angiopathy.
Adult
Asian People
/ statistics & numerical data
Black People
/ statistics & numerical data
Cerebral Revascularization
Cerebrovascular Circulation
Clinical Decision-Making
Disease Progression
Female
France
Humans
Intracranial Hemorrhages
/ etiology
Ischemic Attack, Transient
/ etiology
Male
Mortality
Moyamoya Disease
/ complications
Prognosis
Risk Assessment
Stroke
/ etiology
White People
/ statistics & numerical data
Young Adult
Journal
Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060
Informations de publication
Date de publication:
23 07 2019
23 07 2019
Historique:
received:
27
08
2018
accepted:
11
03
2019
pubmed:
27
6
2019
medline:
8
1
2020
entrez:
27
6
2019
Statut:
ppublish
Résumé
To identify independent predictors of clinical or cerebral lesion progression in a large sample of adult patients with moyamoya angiopathy (MMA) prior to decisions regarding revascularization surgery. Ninety participants (median age, 37.5 years) were assessed at baseline and followed for a median time of 42.8 months. Incident ischemic and hemorrhagic strokes, death, as well as any incident ischemic and hemorrhagic lesions on MRI were recorded. Multiple demographic, clinical, and cerebral imaging measures at baseline were considered as potential predictors of clinical or cerebral tissue change at follow-up. Data were analyzed based on the Andersen-Gill counting process model, followed by internal validation of the prediction model. Among multiple potential predictive measures considered in the analysis, Asian origin, a history of TIAs, and a reduction in hemodynamic reserve, as detected by imaging, were found to be significantly associated with an increased risk of combined clinical and imaging events. While the model estimated the risk of clinical or cerebral lesion progression to be approximately 0.5% per year when none of these factors was present, this risk exceeded 20% per year when all factors were present. A simple combination of demographic, clinical, and cerebral perfusion imaging measures may aid in predicting the risk of incident stroke and cerebral lesion progression in adult patients with MMA. These results may help to improve therapeutic decisions and aid in the design of future trials in adults with this rare condition.
Identifiants
pubmed: 31239360
pii: WNL.0000000000007819
doi: 10.1212/WNL.0000000000007819
pmc: PMC6669931
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e388-e397Informations de copyright
Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.
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