Long-Term Risk of Arterial Thrombosis After Intracerebral Hemorrhage: MUCH-Italy-Reference-Cited by-同舟云学术

Long-Term Risk of Arterial Thrombosis After Intracerebral Hemorrhage: MUCH-Italy

Published:2024-03 Issue:3 Volume:55 Page:634-642
ISSN:0039-2499
Container-title:Stroke
language:en
Short-container-title:Stroke

Author:

Pezzini Alessandro¹²^ORCID,Iacoviello Licia³⁴,Di Castelnuovo Augusto⁵^ORCID,Costanzo Simona³^ORCID,Tarantino Barbara⁶^ORCID,de Gaetano Giovanni⁷^ORCID,Zedde Marialuisa⁸^ORCID,Marcheselli Simona⁹^ORCID,Silvestrelli Giorgio¹⁰^ORCID,Ciccone Alfonso¹⁰^ORCID,DeLodovici Maria Luisa¹¹^ORCID,Princiotta Cariddi Lucia¹¹^ORCID,Paciaroni Maurizio¹²^ORCID,Azzini Cristiano¹³^ORCID,Padroni Marina¹³^ORCID,Gamba Massimo¹⁴,Magoni Mauro¹⁴,Del Sette Massimo¹⁵,Tassi Rossana¹⁶^ORCID,De Franco Ivo Giuseppe¹⁶,Cavallini Anna¹⁷^ORCID,Calabrò Rocco Salvatore¹⁸,Cappellari Manuel¹⁹^ORCID,Giorli Elisa²⁰,Giacalone Giacomo³^ORCID,Lodigiani Corrado²¹,Zenorini Mara¹⁹,Valletta Francesco¹⁹,Pascarella Rosario²²^ORCID,Grisendi Ilaria⁸^ORCID,Assenza Federica⁸^ORCID,Napoli Manuela²²^ORCID,Moratti Claudio²²^ORCID,Acampa Maurizio¹⁶^ORCID,Grassi Mario⁶^ORCID,

Affiliation:

1. Dipartimento di Medicina e Chirurgia, Università degli Studi di Parma, Italy (A.P.).

2. Programma Stroke Care, Dipartimento di Emergenza-Urgenza, Azienda Ospedaliera Universitaria, Parma, Italy (A.P.).

3. Dipartimento di Epidemiologia e Prevenzione, IRCCS Neuromed, Pozzilli, Italy (L.I., S.C., G.G.).

4. Dipartimento di Medicina e Chirurgia (L.I.), Università dell’Insubria, Varese, Italy.

5. Mediterranea Cardiocentro, Napoli, Italy (A.D.C.).

6. Dipartimento di Scienze del Sistema Nervoso e del Comportamento, Unità di Statistica Medica e Genomica, Università di Pavia, Italy (B.T., M. Grassi).

7. Stroke Unit, U.O Neurologia, IRCCS Ospedale S. Raffaele, Milano, Italy (G.G.).

8. S.C. Neurologia, Stroke Unit (M. Zedde, I.G., F.A.), AUSL-IRCCS di Reggio Emilia, Italy.

9. Neurologia d’Urgenza and Stroke Unit (S.M.), IRCCS Istituto Clinico Humanitas, Rozzano-Milano, Italy.

10. Stroke Unit, Dipartimento di Neuroscienze, ASST Mantova, Italy (G.S., A. Ciccone).

11. Unità di Neurologia, Ospedale di Circolo (M.L.D.L., L.P.C.), Università dell’Insubria, Varese, Italy.

12. Stroke Unit and Divisione di Medicina Cardiovascolare, Università di Perugia, Italy (M. Paciaroni).

13. Stroke Unit, Divisione di Neurologia, Dipartimento di Neuroscienze e Riabilitazione, Azienda Ospedaliero-Universitaria di Ferrara, Italy (C.A., M. Padroni).

14. Stroke Unit, Neurologia Vascolare, Spedali Civili di Brescia, Italy (M. Gamba, M.M.).

15. U.O. Neurologia, IRCCS Policlinico San Martino, Genova, Italy (M.D.S.).

16. Stroke Unit, AOU Senese, Siena, Italy (R.T., I.G.D.F., M.A.).

17. UOC Malattie Cerebrovascolari e Stroke Unit, IRCCS Fondazione Istituto Neurologico Nazionale “C. Mondino,” Pavia, Italy (A. Cavallini).

18. Istituto di Ricovero e Cura a Carattere Scientifico, Centro Neurolesi Bonino-Pulejo, Messina, Italy (R.S.C.).

19. Stroke Unit, DAI di Neuroscienze, Azienda Ospedaliera Universitaria Integrata Verona, Italy (M.C., M. Zenorini, F.V.).

20. U.O. Neurologia, Ospedale S. Andrea, La Spezia, Italy (E.G.).

21. UOC Centro Trombosi e Malattie Emorragiche (C.L.), IRCCS Istituto Clinico Humanitas, Rozzano-Milano, Italy.

22. SSD Neuroradiologia (R.P., M.N., C.M.), AUSL-IRCCS di Reggio Emilia, Italy.

Abstract

BACKGROUND: The identification of patients surviving an acute intracerebral hemorrhage who are at a long-term risk of arterial thrombosis is a poorly defined, crucial issue for clinicians. METHODS: In the setting of the MUCH-Italy (Multicenter Study on Cerebral Haemorrhage in Italy) prospective observational cohort, we enrolled and followed up consecutive 30-day intracerebral hemorrhage survivors to assess the long-term incidence of arterial thrombotic events, to assess the impact of clinical and radiological variables on the risk of these events, and to develop a tool for estimating such a risk at the individual level. Primary end point was a composite of ischemic stroke, myocardial infarction, or other arterial thrombotic events. A point-scoring system was generated by the β-coefficients of the variables independently associated with the long-term risk of arterial thrombosis, and the predictive MUCH score was calculated as the sum of the weighted scores. RESULTS: Overall, 1729 patients (median follow-up time, 43 months [25th to 75th percentile, 69.0]) qualified for inclusion. Arterial thrombotic events occurred in 169 (9.7%) patients. Male sex, diabetes, hypercholesterolemia, atrial fibrillation, and personal history of coronary artery disease were associated with increased long-term risk of arterial thrombosis, whereas the use of statins and antithrombotic medications after the acute intracerebral hemorrhage was associated with a reduced risk. The area under the receiver operating characteristic curve of the MUCH score predictive validity was 0.716 (95% CI, 0.56–0.81) for the 0- to 1-year score, 0.672 (95% CI, 0.58–0.73) for the 0- to 5-year score, and 0.744 (95% CI, 0.65–0.81) for the 0- to 10-year score. C statistic for the prediction of events that occur from 0 to 10 years was 0.69 (95% CI, 0.64–0.74). CONCLUSIONS: Intracerebral hemorrhage survivors are at high long-term risk of arterial thrombosis. The MUCH score may serve as a simple tool for risk estimation.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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