Five-Year Stroke Risk and Its Predictors in Asymptomatic Moyamoya Disease: Asymptomatic Moyamoya Registry (AMORE).
demography
hemorrhagic stroke
ischemic attack
male
registries
transient
Journal
Stroke
ISSN: 1524-4628
Titre abrégé: Stroke
Pays: United States
ID NLM: 0235266
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
medline:
24
5
2023
pubmed:
22
5
2023
entrez:
22
5
2023
Statut:
ppublish
Résumé
Long-term outcomes are unknown in patients with asymptomatic moyamoya disease. In this report, we aimed to clarify their 5-year risk of stroke and its predictors. We are conducting a multicenter, prospective cohort study (Asymptomatic Moyamoya Registry) in Japan. Participants were eligible if they were 20 to 70 years, had bilateral or unilateral moyamoya disease, experienced no episodes suggestive of TIA and stroke; and were functionally independent (modified Rankin Scale score 0-1). Demographic and radiological information was collected at enrollment. In this study, they are still followed up for 10 years. In this interim analysis, we defined the primary end point as a stroke occurring during a 5-year follow-up period. Independent predictors for stroke were also determined, using a stratification analysis method. Between 2012 and 2015, we enrolled 109 patients, of whom 103 patients with 182 involved hemispheres completed the 5-year follow-up. According to the findings on DSA and MRA, 143 hemispheres were judged as moyamoya disease and 39 hemispheres as questionable manifestations (isolated middle cerebral artery stenosis). The patients with questionable hemispheres were significantly older, more often male, and more frequently had hypertension than those with moyamoya hemisphere. Moyamoya hemispheres developed 7 strokes, including 6 hemorrhagic and 1 ischemic stroke, during the first 5 years. The annual risk of stroke was 1.4% per person, 0.8% per hemisphere, and 1.0% per moyamoya hemisphere. Independent predictor for stroke was Grade-2 choroidal anastomosis (hazard ratio, 5.05 [95% CI, 1.24-20.6]; The hemispheres with asymptomatic moyamoya disease may carry a 1.0% annual risk of stroke during the first 5 years, the majority of which are hemorrhagic stroke. Grade-2 choroidal anastomosis may predict stroke, and the microbleeds and Grade-2 choroidal anastomosis may carry the risk for hemorrhagic stroke. URL: https://www. gov; Unique identifier: UMIN000006640.
Sections du résumé
BACKGROUND
Long-term outcomes are unknown in patients with asymptomatic moyamoya disease. In this report, we aimed to clarify their 5-year risk of stroke and its predictors.
METHODS
We are conducting a multicenter, prospective cohort study (Asymptomatic Moyamoya Registry) in Japan. Participants were eligible if they were 20 to 70 years, had bilateral or unilateral moyamoya disease, experienced no episodes suggestive of TIA and stroke; and were functionally independent (modified Rankin Scale score 0-1). Demographic and radiological information was collected at enrollment. In this study, they are still followed up for 10 years. In this interim analysis, we defined the primary end point as a stroke occurring during a 5-year follow-up period. Independent predictors for stroke were also determined, using a stratification analysis method.
RESULTS
Between 2012 and 2015, we enrolled 109 patients, of whom 103 patients with 182 involved hemispheres completed the 5-year follow-up. According to the findings on DSA and MRA, 143 hemispheres were judged as moyamoya disease and 39 hemispheres as questionable manifestations (isolated middle cerebral artery stenosis). The patients with questionable hemispheres were significantly older, more often male, and more frequently had hypertension than those with moyamoya hemisphere. Moyamoya hemispheres developed 7 strokes, including 6 hemorrhagic and 1 ischemic stroke, during the first 5 years. The annual risk of stroke was 1.4% per person, 0.8% per hemisphere, and 1.0% per moyamoya hemisphere. Independent predictor for stroke was Grade-2 choroidal anastomosis (hazard ratio, 5.05 [95% CI, 1.24-20.6];
CONCLUSIONS
The hemispheres with asymptomatic moyamoya disease may carry a 1.0% annual risk of stroke during the first 5 years, the majority of which are hemorrhagic stroke. Grade-2 choroidal anastomosis may predict stroke, and the microbleeds and Grade-2 choroidal anastomosis may carry the risk for hemorrhagic stroke.
REGISTRATION
URL: https://www.
CLINICALTRIALS
gov; Unique identifier: UMIN000006640.
Identifiants
pubmed: 37216455
doi: 10.1161/STROKEAHA.122.041932
doi:
Banques de données
UMIN-CTR
['UMIN000006640']
Types de publication
Multicenter Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1494-1504Investigateurs
Motoki Inaji
(M)
Kenichi Morita
(K)
Daisuke Maruyama
(D)
Jyoji Nakagawara
(J)
Naoki Hashimura
(N)
Eika Hamano
(E)
Koji Iihara
(K)
Nobuo Hashimoto
(N)
Kaori Honjo
(K)
Hirohiko Nakamura
(H)
Daina Kashiwazaki
(D)
Hideaki Imai
(H)
Satoru Miyawaki
(S)
Hiroki Hongo
(H)
Kazumichi Yoshida
(K)
Takayuki Kikuchi
(T)
Yohei Mineharu
(Y)
Makoto Isozaki
(M)
Kenichiro Kikuta
(K)
Yoshio Araki
(Y)
Fumiaki Kanamori
(F)
Isao Date
(I)
Junichi Ono
(J)
Toshio Machida
(T)
Mitsuhito Mase
(M)
Hiroyuki Katano
(H)
Koji Yamaguchi
(K)
Takakazu Kawamata
(T)
Teiji Tominaga
(T)
Haruto Uchino
(H)
Kikutaro Tokairin
(K)
Masaki Ito
(M)
Kiyohiro Houkin
(K)
Kohei Chida
(K)
Kuniaki Ogasawara
(K)
Izumi Nagata
(I)
Nobutaka Horie
(N)
Hidehiro Oka
(H)
Toshihiro Kumabe
(T)
Yoshiaki Itoh
(Y)
Takato Abe
(T)
Koichi Oki
(K)
Shinichi Takahashi
(S)
Norihiro Suzuki
(N)