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Contribution Of Racial And Ethnic Differences In Cerebral Small Vessel Disease Subtype And Burden To Risk Of Cerebral Hemorrhage Recurrence

J. Castello, M. Pasi, Jessica R Abramson, A. Rodriguez-Torres, S. Marini, S. Demel, Lee A Gilkerson, Patryk Kubiszewski, A. Charidimou, Christina E. Kourkoulis, Zora Y. DiPucchio, K. Schwab, M. Gurol, A. Viswanathan, C. Anderson, C. Langefeld, M. Flaherty, A. Towfighi, S. Greenberg, D. Woo, J. Rosand, A. Biffi
Published 2021 · Medicine

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Objective 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. Methods 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. Results We analyzed data for 922 ICH survivors (655 White, 130 Black, 137 Hispanic). Minority ICH survivors had greater global CSVD (p = 0.011) and HTNA burden (p = 0.021) on MRI. Furthermore, minority survivors of HTNA-related and mixed-etiology ICH demonstrated higher HTNA burden, resulting in increased ICH recurrence risk (all p < 0.05). Conclusions 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.
This paper references
E. Ross (1919)
Recurrence of Bleeding in Patients with Hypertensive Intracerebral Hemorrhage
H. Bae (1999)
Recurrent brain hemorrhage is more frequent than ischemic stroke after intracranial hemorrhage
R. Bailey (2001)
CT and MRI Rating of White Matter Lesions
F. Fazekas (2002)
Controlling the rate of Type I error over a large set of statistical tests.
H. Keselman (2002)
Cerebral microbleeds: a guide to detection and interpretation
S. Greenberg (2009)
Prevalence of Superficial Siderosis in Patients with Cerebral Amyloid Angiopathy
H. Zhang (2010)
Effects of Perindopril-Based Lowering of Blood Pressure on Intracerebral Hemorrhage Related to Amyloid Angiopathy: The PROGRESS Trial
H. Arima (2010)
Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
L. Morgenstern (2010)
Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges
L. Pantoni (2010)
Interrater reliability: the kappa statistic
M. McHugh (2012)
The Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) Study Protocol
D. Woo (2013)
Long-term prognosis after intracerebral haemorrhage: systematic review and meta-analysis
Michael Tin Chung Poon (2013)
Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration
J. Wardlaw (2013)
Mortality after hemorrhagic stroke: data from general practice (The Health Improvement Network)
A Gonzalez-Perez (2013)
tality after hemorrhagic stroke : data from general practice ( The Health Improvement Network )
A Gonzalez-Perez (2013)
Mortality after hemorrhagic stroke: data from general practice (The Health Improvement Network). Neurology
A Gonzalez-Perez (2013)
Stroke subtype, vascular risk factors, and total MRI brain small-vessel disease burden
J. Staals (2014)
A decade of racial and ethnic stroke disparities in the United States
J. Gutierrez (2014)
Association Between Blood Pressure Control and Risk of Recurrent Intracerebral Hemorrhage.
A. Biffi (2015)
Untreated Hypertension: A Powerful Risk Factor for Lobar and Nonlobar Intracerebral Hemorrhage in Whites, Blacks, and Hispanics
Kyle B Walsh (2016)
Total Magnetic Resonance Imaging Burden of Small Vessel Disease in Cerebral Amyloid Angiopathy: An Imaging-Pathologic Study of Concept Validation.
A. Charidimou (2016)
Intracerebral Hemorrhage, Racial Disparities, and Access to Care.
Monika M Safford (2016)
Introduction to the Analysis of Survival Data in the Presence of Competing Risks
P. Austin (2016)
MRI-visible perivascular spaces in cerebral amyloid angiopathy and hypertensive arteriopathy
A. Charidimou (2017)
Distribution of lacunes in cerebral amyloid angiopathy and hypertensive small vessel disease
M. Pasi (2017)
Total small vessel disease score and risk of recurrent stroke
K. Lau (2017)
Cortical superficial siderosis multifocality in cerebral amyloid angiopathy
A. Charidimou (2017)
Hemorrhage recurrence risk factors in cerebral amyloid angiopathy: Comparative analysis of the overall small vessel disease severity score versus individual neuroimaging markers
G. Boulouis (2017)
Hypertension and intracerebral hemorrhage recurrence among white, black, and Hispanic individuals
A. Rodriguez-Torres (2018)
Cerebral small vessel disease and risk of incident stroke, dementia and depression, and all-cause mortality: A systematic review and meta-analysis
Sytze P. Rensma (2018)
Mixed-location cerebral hemorrhage/ microbleeds: underlying microangiopathy and recurrence risk. Neurology
M Pasi (2018)
Five-Year Risk of Major Ischemic and Hemorrhagic Events After Intracerebral Hemorrhage
B. Casolla (2019)
CNS small vessel disease : a clinical review
L Pantoni (2019)
CNS small vessel disease: a clinical review. Neurology
RJ Cannistraro (2019)
Association of apolipoprotein E with intracerebral hemorrhage risk by race/ethnicity: a meta-analysis
S Marini (2019)
Racial/ethnic disparities in the risk of intracerebral hemorrhage recurrence
A. Leasure (2020)
Prevalence of super fi cial siderosis in patients with cerebral amyloid angiopathy
PC Austin
Mixed - location cerebral hemorrhage / microbleeds : underlying microangiopathy and recurrence risk
JM Wardlaw

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