2000 Volume 22 Issue 4 Pages 650-656
A long term follow-up study was coducted with lacunar infarct patients to assess whether or not demographics, conventional risk factors, MRI findings, to include lacunar infarcts and diffuse white matter lesions (DWML), and ambulatory blood pressure monitoring (ABPM) values can predict subsequent development of dementia, stroke recurrence, and/or death.
One hundred fifty patients were tracked (mean follow-up period : 9.2 years) and divided into 5 groups as follows : Group 0, 70 patients with no subsequent event: Group 1, 25 patients who subsequently developed dementia ; Group 2, 15 patients who suffered from a recurrent stroke attack ; Group 3, 18 patients who succumbed to vascular death ; Group 4, 15 patients who died non-vascular death. The risk of each group relative to Group 0 was evaluated for prognostic factors.
Logistic regression analysis demonstrated that age (OR: 1.08; 95% CI : 1.0-1.16), male sex (OR: 8.17; 95% CI : 1.97-33.7), confluent DWML (moderate, OR; 7.7, 95% CI ; 1.9-31.7, severe, OR: 112.8; 95% CI : 15.5-818.2), and non-dippers (OR: 8.57; 95% CI : 1.56-47.0) were independent predictors for dementia, while diabetes mellitus (OR :17.1; 95% CI : 2.95-99.3) and multiple lacunae (moderate, OR; 14, 95% CI ; 2.9-67.6, severe, OR : 44.6 ; 95% CI : 5.3-369.8) were independent prodictors for recurrent stroke. Finally, age (OR :1.09 ; 95% CI : 1.01-1.19), diabetes mellitus (OR: 6.9; 95% CI : 1.1-40.9) and multiple lacunae (moderate, OR; 5.6, 95% CI : 1.3-23.6, severe, OR: 44.6; 95% CI : 5.3-369.8) were independent predictors for vascular death.
Confluent DWML and non-dipper state were independent predictors for subsequent developement of de-mentia, while diabetes mellitus and multiple lacunae were independent predictors for stroke recurrence and cardiovascular death
