Contribution of Racial and Ethnic Differences in Cerebral Small Vessel Disease Subtype and Burden to Risk of Cerebral Hemorrhage Recurrence.
Black or African American
Aged
Aged, 80 and over
Cerebral Amyloid Angiopathy
/ complications
Cerebral Hemorrhage
/ epidemiology
Cerebral Small Vessel Diseases
/ classification
Female
Hispanic or Latino
Humans
Hypertension
/ complications
Longitudinal Studies
Magnetic Resonance Imaging
Male
Middle Aged
Recurrence
Severity of Illness Index
White People
Journal
Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060
Informations de publication
Date de publication:
18 05 2021
18 05 2021
Historique:
received:
29
09
2020
accepted:
24
02
2021
pubmed:
23
4
2021
medline:
1
6
2021
entrez:
22
4
2021
Statut:
ppublish
Résumé
Black and Hispanic survivors of intracerebral hemorrhage (ICH) are at higher risk of recurrent intracranial bleeding. MRI-based markers of chronic cerebral small vessel disease (CSVD) are consistently associated with recurrent ICH. We therefore sought to investigate whether racial/ethnic differences in MRI-defined CSVD subtype and severity contribute to disparities in ICH recurrence risk. We analyzed data from the Massachusetts General Hospital ICH study (n = 593) and the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study (n = 329). Using CSVD markers derived from MRIs obtained within 90 days of index ICH, we classified ICH cases as cerebral amyloid angiopathy (CAA)-related, hypertensive arteriopathy (HTNA)-related, and mixed etiology. We quantified CSVD burden using validated global, CAA-specific, and HTNA-specific scores. We compared CSVD subtype and severity among White, Black, and Hispanic ICH survivors and investigated its association with ICH recurrence risk. We analyzed data for 922 ICH survivors (655 White, 130 Black, 137 Hispanic). Minority ICH survivors had greater global CSVD ( We uncovered significant differences in CSVD subtypes and severity among White and minority survivors of primary ICH, with direct implication for known disparities in ICH recurrence risk. Future studies of racial/ethnic disparities in ICH outcomes will benefit from including detailed MRI-based assessment of CSVD subtypes and severity and investigating social determinants of health.
Identifiants
pubmed: 33883240
pii: WNL.0000000000011932
doi: 10.1212/WNL.0000000000011932
pmc: PMC8205476
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e2469-e2480Subventions
Organisme : NIA NIH HHS
ID : R01 AG026484
Pays : United States
Organisme : NINDS NIH HHS
ID : K23 NS100816
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS093870
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS103924
Pays : United States
Organisme : NINDS NIH HHS
ID : U01 NS069763
Pays : United States
Informations de copyright
© 2021 American Academy of Neurology.
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