Key result
Severe white matter hyperintensities were associated with higher initial stroke severity compared to mild hyperintensities (OR 2.10; 95% CI 1.26-3.48; P=0.004) in minor stroke patients.
Why the study?
To characterize the severity and distribution of white matter hyperintensities and assess their relationship with initial stroke severity, 3-month functional outcome, stroke recurrence, and response to antiplatelet therapies.
Do severe white matter hyperintensities worsen stroke outcomes or alter response to antiplatelet therapy in minor stroke patients?
Cohort (n=787)
Do severe white matter hyperintensities worsen stroke outcomes or alter response to antiplatelet therapy in minor stroke patients?
Severe white matter hyperintensities are associated with higher initial stroke severity in minor stroke patients, but do not significantly impact 3-month functional outcomes, stroke recurrence, or response to antiplatelet therapy.
Answers are grounded in this paper and cite their sources.
May signal greater initial severity in minor stroke; leaves open effects on outcomes or antiplatelet response.
BACKGROUND: To characterize the severity and distribution of white matter hyperintensities (WMHs) and to assess the relationship of WMHs with initial stroke severity, 3-month functional outcome, stroke recurrence and response to antiplatelet therapies. METHODS: In Clopidogrel High-risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial, 787 minor stroke patients with baseline magnetic resonance imaging (MRI) information were included in this analysis. Deep and periventricular WMHs (DWMHs and PVWMHs) were rated using the Fazekas scale and categorized into mild (grades 0-2), moderate (grades 3-4) and severe (grades 5-6). Multivariable logistic regression was used to examine the associations between WMHs severities and outcomes, including initial stroke severity by the National Institutes of Health Stroke Scale (NIHSS) scores, 3-month functional outcome by modified Rankin Scale (mRS), and stroke recurrence. Cox proportional hazards model was used to assess the treatment-by-subgroup interaction effect. RESULTS: Among the 787 patients in this analysis, 432 (54.9%) had moderate or severe WMHs (3-6). Compared with mild WMHs, the adjusted odds ratio (OR) of severe WMHs for risk of higher NIHSS was 2.10, 95% confidence interval (CI), 1.26-3.48 (P=0.004). Both severities of SDWMHs (OR 1.66; 95% CI, 1.15-2.40; P=0.007) and PVWMHs (OR 1.47; 95% CI, 1.02-2.10; P=0.04) were associated with higher NIHSS scores. There were no statistically significant associations of WMHs with 3-month functional outcome and stroke recurrence. There were no significant interactions between WMHs and antiplatelet therapy. CONCLUSIONS: ClinicalTrials.gov identifier: NCT00979589. Date of registration: Sep 18, 2009.
No takes yet. Share an insight, caveat, or question.
Xu et al. (2020) conducted a cohort in Minor stroke (n=787). Severe white matter hyperintensities (WMHs) vs. Mild white matter hyperintensities was evaluated on Higher initial stroke severity by NIHSS scores (OR 2.10, 95% CI 1.26-3.48, p=0.004). Severe white matter hyperintensities were associated with higher initial stroke severity compared to mild hyperintensities (OR 2.10; 95% CI 1.26-3.48; P=0.004) in minor stroke patients.
Synapse has enriched 10 related papers. Consider them for comparative context: