Cerebral Small Vessel Disease Burden and All-Cause Mortality: Mayo Clinic Florida Familial Cerebrovascular Diseases Registry

Eric D. Goldstein, Mohammed K. Badi, Tasneem F. Hasan, Elizabeth R. Lesser, David O. Hodge, Michelle P. Lin, James F. Meschia

Research output: Contribution to journalArticle

Abstract

Goal: Cerebral small vessel disease (CSVD) leads to cognitive decline, gait disturbances, mood changes, and an increased risk of stroke. The goal of this study is to describe the relationship between a composite radiographic CSVD score and all-cause mortality. Materials and Methods: Data were collected from a prospective registry of patients with and without cerebrovascular disease from November 2010 through April 2018. The radiographic Total CSVD Score (tSVD) ranges from 0 (minimal disease) to 4 (severe disease), based on detection of lacunar infarcts, cerebral microbleeds, perivascular spaces, and subcortical or periventricular white matter hyperintensities. All-cause mortality served as the primary endpoint. The independent relationship between CSVD burden and all-cause mortality was assessed using Cox regression models with significance being P < .05. Findings: Four hundred and forty-nine patients were included (mean age, 63 years; 50.1% [225 of 449] women). The hazard ratio for mortality significantly increased with advancing score (1.92, P = .014 score 1; 2.92, P < .001 score 2; 4.23, P < .001 combined scores 3 and 4). Significance remained despite adjustment for coexistent cerebrovascular risk factors aside from age. Conclusions: The clinically practical tSVD score may serve as a predictor for all-cause mortality in populations with high disease prevalence. Continued investigations are needed to better understand the effects of risk factor modification on mortality and pathogenesis with the goal of developing disease modifying therapies.

Original languageEnglish (US)
Article number104285
JournalJournal of Stroke and Cerebrovascular Diseases
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Cerebral Small Vessel Diseases
Cerebrovascular Disorders
Registries
Mortality
Lacunar Stroke
Gait
Proportional Hazards Models
Stroke

Keywords

  • Cerebrovascular disease—stroke—cerebral microangiopathy—mortality—stroke imaging

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Cerebral Small Vessel Disease Burden and All-Cause Mortality : Mayo Clinic Florida Familial Cerebrovascular Diseases Registry. / Goldstein, Eric D.; Badi, Mohammed K.; Hasan, Tasneem F.; Lesser, Elizabeth R.; Hodge, David O.; Lin, Michelle P.; Meschia, James F.

In: Journal of Stroke and Cerebrovascular Diseases, 01.01.2019.

Research output: Contribution to journalArticle

Goldstein, Eric D. ; Badi, Mohammed K. ; Hasan, Tasneem F. ; Lesser, Elizabeth R. ; Hodge, David O. ; Lin, Michelle P. ; Meschia, James F. / Cerebral Small Vessel Disease Burden and All-Cause Mortality : Mayo Clinic Florida Familial Cerebrovascular Diseases Registry. In: Journal of Stroke and Cerebrovascular Diseases. 2019.
@article{9261862ad4a840a7bd9fbbdac7b1bf90,
title = "Cerebral Small Vessel Disease Burden and All-Cause Mortality: Mayo Clinic Florida Familial Cerebrovascular Diseases Registry",
abstract = "Goal: Cerebral small vessel disease (CSVD) leads to cognitive decline, gait disturbances, mood changes, and an increased risk of stroke. The goal of this study is to describe the relationship between a composite radiographic CSVD score and all-cause mortality. Materials and Methods: Data were collected from a prospective registry of patients with and without cerebrovascular disease from November 2010 through April 2018. The radiographic Total CSVD Score (tSVD) ranges from 0 (minimal disease) to 4 (severe disease), based on detection of lacunar infarcts, cerebral microbleeds, perivascular spaces, and subcortical or periventricular white matter hyperintensities. All-cause mortality served as the primary endpoint. The independent relationship between CSVD burden and all-cause mortality was assessed using Cox regression models with significance being P < .05. Findings: Four hundred and forty-nine patients were included (mean age, 63 years; 50.1{\%} [225 of 449] women). The hazard ratio for mortality significantly increased with advancing score (1.92, P = .014 score 1; 2.92, P < .001 score 2; 4.23, P < .001 combined scores 3 and 4). Significance remained despite adjustment for coexistent cerebrovascular risk factors aside from age. Conclusions: The clinically practical tSVD score may serve as a predictor for all-cause mortality in populations with high disease prevalence. Continued investigations are needed to better understand the effects of risk factor modification on mortality and pathogenesis with the goal of developing disease modifying therapies.",
keywords = "Cerebrovascular disease—stroke—cerebral microangiopathy—mortality—stroke imaging",
author = "Goldstein, {Eric D.} and Badi, {Mohammed K.} and Hasan, {Tasneem F.} and Lesser, {Elizabeth R.} and Hodge, {David O.} and Lin, {Michelle P.} and Meschia, {James F.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.jstrokecerebrovasdis.2019.07.001",
language = "English (US)",
journal = "Journal of Stroke and Cerebrovascular Diseases",
issn = "1052-3057",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - Cerebral Small Vessel Disease Burden and All-Cause Mortality

T2 - Mayo Clinic Florida Familial Cerebrovascular Diseases Registry

AU - Goldstein, Eric D.

AU - Badi, Mohammed K.

AU - Hasan, Tasneem F.

AU - Lesser, Elizabeth R.

AU - Hodge, David O.

AU - Lin, Michelle P.

AU - Meschia, James F.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Goal: Cerebral small vessel disease (CSVD) leads to cognitive decline, gait disturbances, mood changes, and an increased risk of stroke. The goal of this study is to describe the relationship between a composite radiographic CSVD score and all-cause mortality. Materials and Methods: Data were collected from a prospective registry of patients with and without cerebrovascular disease from November 2010 through April 2018. The radiographic Total CSVD Score (tSVD) ranges from 0 (minimal disease) to 4 (severe disease), based on detection of lacunar infarcts, cerebral microbleeds, perivascular spaces, and subcortical or periventricular white matter hyperintensities. All-cause mortality served as the primary endpoint. The independent relationship between CSVD burden and all-cause mortality was assessed using Cox regression models with significance being P < .05. Findings: Four hundred and forty-nine patients were included (mean age, 63 years; 50.1% [225 of 449] women). The hazard ratio for mortality significantly increased with advancing score (1.92, P = .014 score 1; 2.92, P < .001 score 2; 4.23, P < .001 combined scores 3 and 4). Significance remained despite adjustment for coexistent cerebrovascular risk factors aside from age. Conclusions: The clinically practical tSVD score may serve as a predictor for all-cause mortality in populations with high disease prevalence. Continued investigations are needed to better understand the effects of risk factor modification on mortality and pathogenesis with the goal of developing disease modifying therapies.

AB - Goal: Cerebral small vessel disease (CSVD) leads to cognitive decline, gait disturbances, mood changes, and an increased risk of stroke. The goal of this study is to describe the relationship between a composite radiographic CSVD score and all-cause mortality. Materials and Methods: Data were collected from a prospective registry of patients with and without cerebrovascular disease from November 2010 through April 2018. The radiographic Total CSVD Score (tSVD) ranges from 0 (minimal disease) to 4 (severe disease), based on detection of lacunar infarcts, cerebral microbleeds, perivascular spaces, and subcortical or periventricular white matter hyperintensities. All-cause mortality served as the primary endpoint. The independent relationship between CSVD burden and all-cause mortality was assessed using Cox regression models with significance being P < .05. Findings: Four hundred and forty-nine patients were included (mean age, 63 years; 50.1% [225 of 449] women). The hazard ratio for mortality significantly increased with advancing score (1.92, P = .014 score 1; 2.92, P < .001 score 2; 4.23, P < .001 combined scores 3 and 4). Significance remained despite adjustment for coexistent cerebrovascular risk factors aside from age. Conclusions: The clinically practical tSVD score may serve as a predictor for all-cause mortality in populations with high disease prevalence. Continued investigations are needed to better understand the effects of risk factor modification on mortality and pathogenesis with the goal of developing disease modifying therapies.

KW - Cerebrovascular disease—stroke—cerebral microangiopathy—mortality—stroke imaging

UR - http://www.scopus.com/inward/record.url?scp=85074437937&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85074437937&partnerID=8YFLogxK

U2 - 10.1016/j.jstrokecerebrovasdis.2019.07.001

DO - 10.1016/j.jstrokecerebrovasdis.2019.07.001

M3 - Article

C2 - 31677962

AN - SCOPUS:85074437937

JO - Journal of Stroke and Cerebrovascular Diseases

JF - Journal of Stroke and Cerebrovascular Diseases

SN - 1052-3057

M1 - 104285

ER -