Prevalence and correlates of silent cerebral infarcts in the framingham offspring study

Rohit R. Das, Sudha Seshadri, Alexa S. Beiser, Margaret Kelly-Hayes, Rhoda Au, Jayandra J. Himali, Carlos S. Kase, Emelia J. Benjamin, Joseph F. Polak, Christopher J. O'Donnell, Mitsuhiro Yoshita, Ralph B. D'Agostino, Charles DeCarli, Philip A. Wolf

Research output: Contribution to journalArticle

210 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE-Previous estimates of the prevalence of silent cerebral infarction (SCI) on MRI in community-based samples have varied between 5.8% and 17.7% depending on age, ethnicity, presence of comorbidities, and imaging techniques. We document the prevalence and risk factors associated with SCI at midlife in the community-based Framingham sample. METHODS-Our study sample comprised 2040 Framingham Offspring (53% female; mean age, 62 ± 9 years) who attended the sixth examination (1996ĝ€"1998), underwent volumetric brain MRI (1999ĝ€"2005,) and were free of clinical stroke at MRI. We examined the age- and sex-specific prevalences and the clinical correlates of SCI using multivariable logistic regression models. RESULTS-At least 1 SCI was present in 10.7% of participants; 84% had a single lesion. SCI was largely located in the basal ganglia (52%), other subcortical (35%) areas, and cortical areas (11%). Prevalent SCI was associated with the Framingham Stroke Risk Profile score (OR, 1.27; 95% CI, 1. 10ĝ€"1.46); stage I hypertension was determined by JNC-7 criteria (OR,1.56; CI,1.15ĝ€"2.11), an elevated plasma homocysteine in the highest quartile (OR, 2.23; CI, 1.42ĝ€"3.51) , atrial fibrillation (OR, 2.16; CI, 1.07ĝ€"4.40), carotid stenosis >25% (OR, 1.62; 1.13ĝ€"2.34), and increased carotid intimal-medial thickness above the lowest quintile (OR, 1.65; CI, 1.22ĝ€"2.24). CONCLUSION-The prevalence and distribution of SCI in the Framingham Offspring are comparable to previous estimates. Risk factors previously associated with clinical stroke were also found to be associated with midlife SCI. Our results support current guidelines emphasizing early detection and treatment of stroke risk factors.

Original languageEnglish (US)
Pages (from-to)2929-2935
Number of pages7
JournalStroke
Volume39
Issue number11
DOIs
StatePublished - Nov 1 2008

Fingerprint

Cerebral Infarction
Stroke
Logistic Models
Tunica Intima
Carotid Stenosis
Homocysteine
Basal Ganglia
Atrial Fibrillation
Comorbidity
Guidelines
Hypertension
Brain

Keywords

  • Carotid intimal medial thickness
  • Carotid stenosis
  • Carotid ultrasound
  • Cerebral infarct
  • Epidemiology
  • Homocysteinemia
  • Imaging
  • Magnetic resonance
  • Prevention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing
  • Medicine(all)

Cite this

Das, R. R., Seshadri, S., Beiser, A. S., Kelly-Hayes, M., Au, R., Himali, J. J., ... Wolf, P. A. (2008). Prevalence and correlates of silent cerebral infarcts in the framingham offspring study. Stroke, 39(11), 2929-2935. https://doi.org/10.1161/STROKEAHA.108.516575

Prevalence and correlates of silent cerebral infarcts in the framingham offspring study. / Das, Rohit R.; Seshadri, Sudha; Beiser, Alexa S.; Kelly-Hayes, Margaret; Au, Rhoda; Himali, Jayandra J.; Kase, Carlos S.; Benjamin, Emelia J.; Polak, Joseph F.; O'Donnell, Christopher J.; Yoshita, Mitsuhiro; D'Agostino, Ralph B.; DeCarli, Charles; Wolf, Philip A.

In: Stroke, Vol. 39, No. 11, 01.11.2008, p. 2929-2935.

Research output: Contribution to journalArticle

Das, RR, Seshadri, S, Beiser, AS, Kelly-Hayes, M, Au, R, Himali, JJ, Kase, CS, Benjamin, EJ, Polak, JF, O'Donnell, CJ, Yoshita, M, D'Agostino, RB, DeCarli, C & Wolf, PA 2008, 'Prevalence and correlates of silent cerebral infarcts in the framingham offspring study', Stroke, vol. 39, no. 11, pp. 2929-2935. https://doi.org/10.1161/STROKEAHA.108.516575
Das RR, Seshadri S, Beiser AS, Kelly-Hayes M, Au R, Himali JJ et al. Prevalence and correlates of silent cerebral infarcts in the framingham offspring study. Stroke. 2008 Nov 1;39(11):2929-2935. https://doi.org/10.1161/STROKEAHA.108.516575
Das, Rohit R. ; Seshadri, Sudha ; Beiser, Alexa S. ; Kelly-Hayes, Margaret ; Au, Rhoda ; Himali, Jayandra J. ; Kase, Carlos S. ; Benjamin, Emelia J. ; Polak, Joseph F. ; O'Donnell, Christopher J. ; Yoshita, Mitsuhiro ; D'Agostino, Ralph B. ; DeCarli, Charles ; Wolf, Philip A. / Prevalence and correlates of silent cerebral infarcts in the framingham offspring study. In: Stroke. 2008 ; Vol. 39, No. 11. pp. 2929-2935.
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abstract = "BACKGROUND AND PURPOSE-Previous estimates of the prevalence of silent cerebral infarction (SCI) on MRI in community-based samples have varied between 5.8{\%} and 17.7{\%} depending on age, ethnicity, presence of comorbidities, and imaging techniques. We document the prevalence and risk factors associated with SCI at midlife in the community-based Framingham sample. METHODS-Our study sample comprised 2040 Framingham Offspring (53{\%} female; mean age, 62 ± 9 years) who attended the sixth examination (1996ĝ€{"}1998), underwent volumetric brain MRI (1999ĝ€{"}2005,) and were free of clinical stroke at MRI. We examined the age- and sex-specific prevalences and the clinical correlates of SCI using multivariable logistic regression models. RESULTS-At least 1 SCI was present in 10.7{\%} of participants; 84{\%} had a single lesion. SCI was largely located in the basal ganglia (52{\%}), other subcortical (35{\%}) areas, and cortical areas (11{\%}). Prevalent SCI was associated with the Framingham Stroke Risk Profile score (OR, 1.27; 95{\%} CI, 1. 10ĝ€{"}1.46); stage I hypertension was determined by JNC-7 criteria (OR,1.56; CI,1.15ĝ€{"}2.11), an elevated plasma homocysteine in the highest quartile (OR, 2.23; CI, 1.42ĝ€{"}3.51) , atrial fibrillation (OR, 2.16; CI, 1.07ĝ€{"}4.40), carotid stenosis >25{\%} (OR, 1.62; 1.13ĝ€{"}2.34), and increased carotid intimal-medial thickness above the lowest quintile (OR, 1.65; CI, 1.22ĝ€{"}2.24). CONCLUSION-The prevalence and distribution of SCI in the Framingham Offspring are comparable to previous estimates. Risk factors previously associated with clinical stroke were also found to be associated with midlife SCI. Our results support current guidelines emphasizing early detection and treatment of stroke risk factors.",
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T1 - Prevalence and correlates of silent cerebral infarcts in the framingham offspring study

AU - Das, Rohit R.

AU - Seshadri, Sudha

AU - Beiser, Alexa S.

AU - Kelly-Hayes, Margaret

AU - Au, Rhoda

AU - Himali, Jayandra J.

AU - Kase, Carlos S.

AU - Benjamin, Emelia J.

AU - Polak, Joseph F.

AU - O'Donnell, Christopher J.

AU - Yoshita, Mitsuhiro

AU - D'Agostino, Ralph B.

AU - DeCarli, Charles

AU - Wolf, Philip A.

PY - 2008/11/1

Y1 - 2008/11/1

N2 - BACKGROUND AND PURPOSE-Previous estimates of the prevalence of silent cerebral infarction (SCI) on MRI in community-based samples have varied between 5.8% and 17.7% depending on age, ethnicity, presence of comorbidities, and imaging techniques. We document the prevalence and risk factors associated with SCI at midlife in the community-based Framingham sample. METHODS-Our study sample comprised 2040 Framingham Offspring (53% female; mean age, 62 ± 9 years) who attended the sixth examination (1996ĝ€"1998), underwent volumetric brain MRI (1999ĝ€"2005,) and were free of clinical stroke at MRI. We examined the age- and sex-specific prevalences and the clinical correlates of SCI using multivariable logistic regression models. RESULTS-At least 1 SCI was present in 10.7% of participants; 84% had a single lesion. SCI was largely located in the basal ganglia (52%), other subcortical (35%) areas, and cortical areas (11%). Prevalent SCI was associated with the Framingham Stroke Risk Profile score (OR, 1.27; 95% CI, 1. 10ĝ€"1.46); stage I hypertension was determined by JNC-7 criteria (OR,1.56; CI,1.15ĝ€"2.11), an elevated plasma homocysteine in the highest quartile (OR, 2.23; CI, 1.42ĝ€"3.51) , atrial fibrillation (OR, 2.16; CI, 1.07ĝ€"4.40), carotid stenosis >25% (OR, 1.62; 1.13ĝ€"2.34), and increased carotid intimal-medial thickness above the lowest quintile (OR, 1.65; CI, 1.22ĝ€"2.24). CONCLUSION-The prevalence and distribution of SCI in the Framingham Offspring are comparable to previous estimates. Risk factors previously associated with clinical stroke were also found to be associated with midlife SCI. Our results support current guidelines emphasizing early detection and treatment of stroke risk factors.

AB - BACKGROUND AND PURPOSE-Previous estimates of the prevalence of silent cerebral infarction (SCI) on MRI in community-based samples have varied between 5.8% and 17.7% depending on age, ethnicity, presence of comorbidities, and imaging techniques. We document the prevalence and risk factors associated with SCI at midlife in the community-based Framingham sample. METHODS-Our study sample comprised 2040 Framingham Offspring (53% female; mean age, 62 ± 9 years) who attended the sixth examination (1996ĝ€"1998), underwent volumetric brain MRI (1999ĝ€"2005,) and were free of clinical stroke at MRI. We examined the age- and sex-specific prevalences and the clinical correlates of SCI using multivariable logistic regression models. RESULTS-At least 1 SCI was present in 10.7% of participants; 84% had a single lesion. SCI was largely located in the basal ganglia (52%), other subcortical (35%) areas, and cortical areas (11%). Prevalent SCI was associated with the Framingham Stroke Risk Profile score (OR, 1.27; 95% CI, 1. 10ĝ€"1.46); stage I hypertension was determined by JNC-7 criteria (OR,1.56; CI,1.15ĝ€"2.11), an elevated plasma homocysteine in the highest quartile (OR, 2.23; CI, 1.42ĝ€"3.51) , atrial fibrillation (OR, 2.16; CI, 1.07ĝ€"4.40), carotid stenosis >25% (OR, 1.62; 1.13ĝ€"2.34), and increased carotid intimal-medial thickness above the lowest quintile (OR, 1.65; CI, 1.22ĝ€"2.24). CONCLUSION-The prevalence and distribution of SCI in the Framingham Offspring are comparable to previous estimates. Risk factors previously associated with clinical stroke were also found to be associated with midlife SCI. Our results support current guidelines emphasizing early detection and treatment of stroke risk factors.

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KW - Carotid stenosis

KW - Carotid ultrasound

KW - Cerebral infarct

KW - Epidemiology

KW - Homocysteinemia

KW - Imaging

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KW - Prevention

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