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Risk factors for lacune subtypes in the Atherosclerosis Risk in Communities (ARIC) Study.

TitleRisk factors for lacune subtypes in the Atherosclerosis Risk in Communities (ARIC) Study.
Publication TypeJournal Article
Year of Publication2012
AuthorsBezerra DC, Sharrett ARichey, Matsushita K, Gottesman RF, Shibata D, Mosley TH, Coresh JJ, Szklo M, Carvalho MS
Secondary AuthorsSelvin E
JournalNeurology
Volume78
Issue2
Pagination102-8
Date Published2012 Jan 10
ISSN1526-632X
KeywordsAtherosclerosis, Brain, Cholesterol, HDL, Cross-Sectional Studies, Diabetes Mellitus, Ethnic Groups, Female, Follow-Up Studies, Glycated Hemoglobin A, Humans, Hypertension, Magnetic Resonance Imaging, Male, Middle Aged, Models, Statistical, Prevalence, Residence Characteristics, Risk Factors, Stroke, Lacunar
Abstract

OBJECTIVE: Lacunar infarctions are mainly due to 2 microvascular pathologies: lipohyalinosis and microatheroma. Little is known about risk factor differences for these subtypes. We hypothesized that diabetes and glycated hemoglobin (HbA(1)c) would be related preferentially to the lipohyalinotic subtype.

METHODS: We performed a cross-section analysis of the brain MRI data from 1,827 participants in the Atherosclerosis Risk in Communities study. We divided subcortical lesions ≤ 20 mm in diameter into those ≤ 7 mm (of probable lipohyalinotic etiology) and 8-20 mm (probably due to microatheroma) and used Poisson regression to investigate associations with the number of each type of lesion. Unlike previous studies, we also fitted a model involving lesions

RESULTS: Age (prevalence ratio [PR] 1.11 per year; 95% confidence interval [CI] 1.08-1.14), black ethnicity (vs white, PR 1.66; 95% CI 1.27-2.16), hypertension (PR 2.12; 95% CI 1.61-2.79), diabetes (PR 1.42; 95% CI 1.08-1.87), and ever-smoking (PR 1.34; 95% CI 1.04-1.74) were significantly associated with lesions ≤ 7 mm. Findings were similar for lesions

CONCLUSIONS: Smaller lacunes (even those

DOI10.1212/WNL.0b013e31823efc42
Alternate JournalNeurology
PubMed ID22170882
PubMed Central IDPMC3466671
Grant ListHHSN268201100009C / / PHS HHS / United States
HHSN268201100010C / / PHS HHS / United States
HHSN268201100008C / / PHS HHS / United States
HHSN268201100012C / / PHS HHS / United States
HHSN268201100007C / / PHS HHS / United States
HSN268201100005C / / PHS HHS / United States
HHSN268201100011C / / PHS HHS / United States
HHSN268201100006C / / PHS HHS / United States