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Separate prediction of intracerebral hemorrhage and ischemic stroke.

TitleSeparate prediction of intracerebral hemorrhage and ischemic stroke.
Publication TypeJournal Article
Year of Publication2014
AuthorsFerket BS, van Kempen BJH, Wieberdink RG, Steyerberg EW, Koudstaal PJ, Hofman A, Shahar E, Gottesman RF, Rosamond WD, Kizer JR, Kronmal RA, Psaty BM, Longstreth WT, Mosley T, Folsom AR, Hunink MGMyriam
Secondary AuthorsM Ikram A
JournalNeurology
Volume82
Issue20
Pagination1804-12
Date Published2014 May 20
ISSN1526-632X
KeywordsAged, Aged, 80 and over, Atherosclerosis, Body Mass Index, Brain Ischemia, Cholesterol, Female, Humans, Incidence, Intracranial Hemorrhages, Male, Middle Aged, Models, Statistical, Predictive Value of Tests, Risk Assessment, Risk Factors, Stroke
Abstract

OBJECTIVES: To develop and validate 10-year cumulative incidence functions of intracerebral hemorrhage (ICH) and ischemic stroke (IS).

METHODS: We used data on 27,493 participants from 3 population-based cohort studies: the Atherosclerosis Risk in Communities Study, median age 54 years, 45% male, median follow-up 20.7 years; the Rotterdam Study, median age 68 years, 38% male, median follow-up 14.3 years; and the Cardiovascular Health Study, median age 71 years, 41% male, median follow-up 12.8 years. Among these participants, 325 ICH events, 2,559 IS events, and 9,909 nonstroke deaths occurred. We developed 10-year cumulative incidence functions for ICH and IS using stratified Cox regression and competing risks analysis. Basic models including only established nonlaboratory risk factors were extended with diastolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, body mass index, waist-to-hip ratio, and glomerular filtration rate. The cumulative incidence functions' performances were cross-validated in each cohort separately by Harrell C-statistic and calibration plots.

RESULTS: High total cholesterol/high-density lipoprotein cholesterol ratio decreased the ICH rates but increased IS rates (p for difference across stroke types

CONCLUSIONS: We developed and cross-validated cumulative incidence functions for separate prediction of 10-year ICH and IS risk. These functions can be useful to further specify an individual's stroke risk.

DOI10.1212/WNL.0000000000000427
Alternate JournalNeurology
PubMed ID24759844
PubMed Central IDPMC4035707
Grant ListN01HC85080 / HC / NHLBI NIH HHS / United States
HHSN268201100005C / / PHS HHS / United States
HHSN268201100009C / / PHS HHS / United States
HHSN268201100010C / / PHS HHS / United States
N01HC85081 / HC / NHLBI NIH HHS / United States
N01HC85079 / HC / NHLBI NIH HHS / United States
HHSN268201100008C / / PHS HHS / United States
HHSN268201100012C / / PHS HHS / United States
N01HC85086 / HC / NHLBI NIH HHS / United States
N01HC85082 / HC / NHLBI NIH HHS / United States
HHSN268201100007C / / PHS HHS / United States
HHSN268200800007C / / PHS HHS / United States
HHSN268201100011C / / PHS HHS / United States
HHSN268201200036C / / PHS HHS / United States
HL080295 / HL / NHLBI NIH HHS / United States
N01HC85083 / HC / NHLBI NIH HHS / United States
HHSN268201100006C / / PHS HHS / United States
AG023629 / AG / NIA NIH HHS / United States
N01 HC55222 / HC / NHLBI NIH HHS / United States