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Association Between Intracerebral Hemorrhage and Subsequent Arterial Ischemic Events in Participants From 4 Population-Based Cohort Studies

By Currents Editor posted 06-01-2021 08:40


JAMA Neurology (05/03/21) DOI: 10.1001/jamaneurol.2021.0925

Murthy, Santosh B.; Zhang, Cenai; Diaz, Ivan; et al.

Intracerebral hemorrhage correlated with a greater risk of ischemic stroke and myocardial infarction, according to data from four population-based cohort studies. "These findings suggest that intracerebral hemorrhage may be a novel risk marker for arterial ischemic events," the researchers wrote. For the study, the team analyzed pooled data from four population-based, U.S. studies: the Atherosclerosis Risk in Communities (ARIC) study, the Cardiovascular Health Study (CHS), the Northern Manhattan Study (NOMAS), and the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. The data examined was for 47,866 patients enrolled between 1987 and 2007, with the last available follow-up Dec. 31, 2018. The primary outcome was an arterial ischemic event, a composite of ischemic stroke or myocardial infarction. Over a median follow-up of 12.7 years, there were 318 cerebral hemorrhages and 7,648 arterial ischemic events. The incidence of an arterial ischemic event was 3.6 events per 100 person–years after intracerebral hemorrhage, compared with 1.1 events per 100 person–years for individuals who did not have an intracerebral hemorrhage. There was a correlation between intracerebral hemorrhage and arterial ischemic events and myocardial infarction in adjusted models. Additionally, sensitivity analyses showed a correlation between intracerebral hemorrhage and arterial ischemic events in the following settings: when updating covariates in a time-varying manner; when using incidence density matching; when including participants with prevalent intracerebral hemorrhage, ischemic stroke, or myocardial infarction, and when using death as a competing risk.


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