Risk of intracranial haemorrhage and ischaemic stroke after convexity subarachnoid haemorrhage in cerebral amyloid angiopathy

To investigate the frequency, time-course and predictors of intracerebral haemorrhage (ICH), recurrent convexity subarachnoid haemorrhage (cSAH), and ischemic stroke after cSAH associated with cerebral amyloid angiopathy (CAA). We performed a systematic review and international individual patient-da...

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Detalles Bibliográficos
Autores: Hostettler, Isabel Charlotte|||0000-0002-9004-2540, Wilson, Duncan, Fiebelkorn, Catherine Arnold, Aum, Diane, Ameriso, Sebastián Francisco, Eberbach, Federico, Beitzke, Markus, Kleinig, Timothy|||0000-0003-4430-3276, Phan, Thanh|||0000-0003-3400-6323, Marchina, Sarah, Schneckenburger, Romain, Carmona Iragui, Maria|||0000-0001-6914-2339, Charidimou, Andreas, Mourand, Isabelle, Parreira, Sara, Ambler, Gareth, Jäger, Hans Rolf|||0000-0002-6403-4184, Singhal, Shaloo, Ly, John, Ma, Henry|||0000-0002-0510-8059, Touzé, Emmanuel, Geraldes, Ruth|||0000-0001-5829-808X, Fonseca, Ana Catarina|||0000-0001-6913-5526, Melo, Teresa, Labauge, Pierre, Lefèvre, Pierre-Henry, Viswanathan, Anand, Greenberg, Steven Mark, Fortea, Juan|||0000-0002-1340-638X, Apoil, Marion, Boulanger, Marion, Viader, Fausto, Kumar, Sandeep, Srikanth, Velandai, Khurram, Ashan, Fazekas, Franz|||0000-0001-8155-7799, Bruno, Veronica, Zipfel, Gregory Joseph, Refai, Daniel, Rabinstein, Alejandro, Graff-Radford, Jonathan, Werring, David John
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:256510
Acceso en línea:https://ddd.uab.cat/record/256510
https://dx.doi.org/urn:doi:10.1007/s00415-021-10706-3
Access Level:acceso abierto
Palabra clave:Non-traumatic convexity/convexal/cortical subarachnoid haemorrhage
Intracerebral haemorrhage
Ischemic stroke
Cerebral amyloid angiopathy
Stroke
Descripción
Sumario:To investigate the frequency, time-course and predictors of intracerebral haemorrhage (ICH), recurrent convexity subarachnoid haemorrhage (cSAH), and ischemic stroke after cSAH associated with cerebral amyloid angiopathy (CAA). We performed a systematic review and international individual patient-data pooled analysis in patients with cSAH associated with probable or possible CAA diagnosed on baseline MRI using the modified Boston criteria. We used Cox proportional hazards models with a frailty term to account for between-cohort differences. We included 190 patients (mean age 74.5 years; 45.3% female) from 13 centers with 385 patient-years of follow-up (median 1.4 years). The risks of each outcome (per patient-year) were: ICH 13.2% (95% CI 9.9-17.4); recurrent cSAH 11.1% (95% CI 7.9-15.2); combined ICH, cSAH, or both 21.4% (95% CI 16.7-26.9), ischemic stroke 5.1% (95% CI 3.1-8) and death 8.3% (95% CI 5.6-11.8). In multivariable models, there is evidence that patients with probable CAA (compared to possible CAA) had a higher risk of ICH (HR 8.45, 95% CI 1.13-75.5, p = 0.02) and cSAH (HR 3.66, 95% CI 0.84-15.9, p = 0.08) but not ischemic stroke (HR 0.56, 95% CI 0.17-1.82, p = 0.33) or mortality (HR 0.54, 95% CI 0.16-1.78, p = 0.31). Patients with cSAH associated with probable or possible CAA have high risk of future ICH and recurrent cSAH. Convexity SAH associated with probable (vs possible) CAA is associated with increased risk of ICH, and cSAH but not ischemic stroke. Our data provide precise risk estimates for key vascular events after cSAH associated with CAA which can inform management decisions. The online version contains supplementary material available at 10.1007/s00415-021-10706-3.

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