SPS3 Coordinating Center.
Clinical–MRI correlations in a multiethnic cohort with recent lacunar stroke: the SPS3 trial
Article first published online: 27 MAY 2014
© 2014 World Stroke Organization
International Journal of Stroke
Volume 9, Issue 8, pages 1057–1064, December 2014
How to Cite
Benavente, O. R., Pearce, L. A., Bazan, C., Roldan, A. M., Catanese, L., Bhat Livezey, V. M., Vidal-Pergola, G., McClure, L. A., Hart, R. G. and SPS3 Investigators (2014), Clinical–MRI correlations in a multiethnic cohort with recent lacunar stroke: the SPS3 trial. International Journal of Stroke, 9: 1057–1064. doi: 10.1111/ijs.12282
Funding: SPS3 was supported by a cooperative agreement (U01NS038529) from the US National Institute of Health-National Institute of Neurological Disorders and Stroke (NIH-NINDS).
‘Clinical Trial Registration’ www.clinicaltrials.gov NCT00059306.
Conflicts of interest: The authors declare that they have no conflicts of interest.
- Issue published online: 10 NOV 2014
- Article first published online: 27 MAY 2014
- Manuscript Accepted: 3 MAR 2014
- Manuscript Received: 24 SEP 2013
- US National Institute of Health-National Institute of Neurological Disorders and Stroke (NIH-NINDS). Grant Number: U01NS038529
- lacunar stroke;
- African American;
- small vessel disease;
- white matter hyperintensity
Neuroimaging manifestations of small vessel disease are heterogeneous, and correlation with patient features has not been adequately characterized.
Our goal was to correlate magnetic resonance imaging findings with clinical features in a large multiethnic cohort with recent lacunar stroke.
Patient characteristics were correlated with neuroimaging results in the Secondary Prevention of Small Subcortical Stroke study participants.
Among 3005 patients, mean age was 63 years; 62% were men; and 51%, 30%, and 16% were non-Hispanic White, Hispanic, and Black, respectively. Recent lacunar infarcts were distributed between the subcortical hemisphere (31%), thalamus (26%), brainstem/cerebellum (26%), and basal ganglia/internal capsule (16%). Multiple lacunar infarcts (i.e., acute and remote) were present in 40% and associated with increased age (OR 1·3 per 20 years, 95% CI 1·1, 1·5), male gender (OR 1·5, CI 1·3, 1·7), hypertension (OR 1·5, CI 1·2, 1·8), increased systolic blood pressure (OR 1·2 per 20 mmHg, CI 1·1, 1·3), and prior stroke (OR 3·8, CI 2·9, 5·0). Moderate-severe white matter hyperintensities were present in 50% and associated with increased age (OR 4·3 per 20 years, CI 3·4, 5·4), hypertension (OR 1·8, CI 1·4, 2·3), increased systolic blood pressure (OR 1·3 per 20 mmHg, CI 1·1, 1·5), increased diastolic blood pressure (OR 1·2 per 10 mm, CI 1·0, 1·3), and prior stroke (OR 3·3, CI 2·3, 4·5). Infarct location varied significantly by race-ethnicity (P < 0·001), with Blacks and Hispanics having more infarcts in the brainstem/cerebellum than non-Hispanic Whites, and by gender with women more often having thalamic lacunes than men (P ≤ 0·001).
In patients with recent lacunar stroke, infarct location and number have distinctie associations with gender, vascular risk factors, and race-ethnicity, demonstrating the complex pathogenesis of lacunar stroke and cerebral small artery disease.