Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/20841
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dc.contributor.authorWilson, Duncan-
dc.contributor.authorAmbler, Gareth-
dc.contributor.authorLee, Keon-Joo-
dc.contributor.authorLim, Jae-Sung-
dc.contributor.authorShiozawa, Masayuki-
dc.contributor.authorKoga, Masatoshi-
dc.contributor.authorLi, Linxin-
dc.contributor.authorLovelock, Caroline-
dc.contributor.authorChabriat, Hugues-
dc.contributor.authorHennerici, Michael-
dc.contributor.authorWong, Yuen Kwun-
dc.contributor.authorChen, Christopher-
dc.contributor.authorLou, Min-
dc.contributor.authorStaals, Julie-
dc.contributor.authorBordet, Régis-
dc.contributor.authorKandiah, Nagaendran-
dc.contributor.authorde Leeuw, Frank-Erik-
dc.contributor.authorSimister, Robert-
dc.contributor.authorvan der Lugt, Aad-
dc.contributor.authorKelly, Peter J-
dc.contributor.authorWardlaw, Joanna M-
dc.contributor.authorSrikanth, Velandai-
dc.contributor.authorSoo, Yannie-
dc.contributor.authorFluri, Felix-
dc.contributor.authorCalvet, David-
dc.contributor.authorJung, Simon-
dc.contributor.authorKwa, Vincent I H-
dc.contributor.authorEngelter, Stefan T-
dc.contributor.authorPeters, Nils-
dc.contributor.authorSmith, Eric E-
dc.contributor.authorYakushiji, Yusuke-
dc.contributor.authorOrken, Dilek Necioglu-
dc.contributor.authorFazekas, Franz-
dc.contributor.authorMok, Vincent-
dc.contributor.authorThijs, Vincent N-
dc.contributor.authorHeo, Ji Hoe-
dc.contributor.authorVeltkamp, Roland-
dc.contributor.authorAy, Hakan-
dc.contributor.authorImaizumi, Toshio-
dc.contributor.authorGomez-Anson, Beatriz-
dc.contributor.authorLau, Kui Kai-
dc.contributor.authorJouvent, Eric-
dc.contributor.authorRothwell, Peter M-
dc.contributor.authorToyoda, Kazunori-
dc.contributor.authorBae, Hee-Joon-
dc.contributor.authorMak, Henry Ka Fung-
dc.contributor.authorMarti-Fabregas, Joan-
dc.contributor.authorWerring, David J-
dc.contributor.authorPrats-Sánchez, Luis-
dc.contributor.authorMartínez-Domeño, Alejandro-
dc.contributor.authorInamura, Shigeru-
dc.contributor.authorYoshifuji, Kazuhisa-
dc.contributor.authorArsava, Ethem Murat-
dc.contributor.authorHorstmann, Solveig-
dc.contributor.authorPurrucker, Jan-
dc.contributor.authorLam, Bonnie Yin Ka-
dc.contributor.authorWong, Adrian-
dc.contributor.authorKim, Young Dae-
dc.contributor.authorSong, Tae-Jin-
dc.contributor.authorSchrooten, Maarten-
dc.contributor.authorLemmens, Robin-
dc.contributor.authorEppinger, Sebastian-
dc.contributor.authorGattringer, Thomas-
dc.contributor.authorUysal, Ender-
dc.contributor.authorTanriverdi, Zeynep-
dc.contributor.authorBornstein, Natan M-
dc.contributor.authorAssayag, Einor Ben-
dc.contributor.authorHallevi, Hen-
dc.contributor.authorTanaka, Jun-
dc.contributor.authorHara, Hideo-
dc.contributor.authorCoutts, Shelagh B-
dc.contributor.authorHert, Lisa-
dc.contributor.authorPolymeris, Alexandros-
dc.contributor.authorSeiffge, David J-
dc.contributor.authorLyrer, Philippe-
dc.contributor.authorAlgra, Ale-
dc.contributor.authorKappelle, Jaap-
dc.contributor.authorAl-Shahi Salman, Rustam-
dc.contributor.authorJäger, Hans R-
dc.contributor.authorLip, Gregory Y H-
dc.contributor.authorMattle, Heinrich P-
dc.contributor.authorPanos, Leonidas D-
dc.contributor.authorMas, Jean-Louis-
dc.contributor.authorLegrand, Laurence-
dc.contributor.authorKarayiannis, Christopher-
dc.contributor.authorPhan, Thanh-
dc.contributor.authorGunkel, Sarah-
dc.contributor.authorChrist, Nicolas-
dc.contributor.authorAbrigo, Jill-
dc.contributor.authorLeung, Thomas-
dc.contributor.authorChu, Winnie-
dc.contributor.authorChappell, Francesca-
dc.contributor.authorMakin, Stephen-
dc.contributor.authorHayden, Derek-
dc.contributor.authorWilliams, David J-
dc.contributor.authorKooi, M Eline-
dc.contributor.authorvan Dam-Nolen, Dianne H K-
dc.contributor.authorBarbato, Carmen-
dc.contributor.authorBrowning, Simone-
dc.contributor.authorWiegertjes, Kim-
dc.contributor.authorTuladhar, Anil M-
dc.contributor.authorMaaijwee, Noortje-
dc.contributor.authorGuevarra, Christine-
dc.contributor.authorYatawara, Chathuri-
dc.contributor.authorMendyk, Anne-Marie-
dc.contributor.authorDelmaire, Christine-
dc.contributor.authorKöhler, Sebastian-
dc.contributor.authorvan Oostenbrugge, Robert-
dc.contributor.authorZhou, Ying-
dc.contributor.authorXu, Chao-
dc.contributor.authorHilal, Saima-
dc.contributor.authorGyanwali, Bibek-
dc.date2019-05-22-
dc.date.accessioned2019-06-05T01:28:38Z-
dc.date.available2019-06-05T01:28:38Z-
dc.date.issued2019-07-
dc.identifier.citationThe Lancet. Neurology 2019; 18(7): 653-665en_US
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/20841-
dc.description.abstractCerebral microbleeds are a neuroimaging biomarker of stroke risk. A crucial clinical question is whether cerebral microbleeds indicate patients with recent ischaemic stroke or transient ischaemic attack in whom the rate of future intracranial haemorrhage is likely to exceed that of recurrent ischaemic stroke when treated with antithrombotic drugs. We therefore aimed to establish whether a large burden of cerebral microbleeds or particular anatomical patterns of cerebral microbleeds can identify ischaemic stroke or transient ischaemic attack patients at higher absolute risk of intracranial haemorrhage than ischaemic stroke. We did a pooled analysis of individual patient data from cohort studies in adults with recent ischaemic stroke or transient ischaemic attack. Cohorts were eligible for inclusion if they prospectively recruited adult participants with ischaemic stroke or transient ischaemic attack; included at least 50 participants; collected data on stroke events over at least 3 months follow-up; used an appropriate MRI sequence that is sensitive to magnetic susceptibility; and documented the number and anatomical distribution of cerebral microbleeds reliably using consensus criteria and validated scales. Our prespecified primary outcomes were a composite of any symptomatic intracranial haemorrhage or ischaemic stroke, symptomatic intracranial haemorrhage, and symptomatic ischaemic stroke. We registered this study with the PROSPERO international prospective register of systematic reviews, number CRD42016036602. Between Jan 1, 1996, and Dec 1, 2018, we identified 344 studies. After exclusions for ineligibility or declined requests for inclusion, 20 322 patients from 38 cohorts (over 35 225 patient-years of follow-up; median 1·34 years [IQR 0·19-2·44]) were included in our analyses. The adjusted hazard ratio [aHR] comparing patients with cerebral microbleeds to those without was 1·35 (95% CI 1·20-1·50) for the composite outcome of intracranial haemorrhage and ischaemic stroke; 2·45 (1·82-3·29) for intracranial haemorrhage and 1·23 (1·08-1·40) for ischaemic stroke. The aHR increased with increasing cerebral microbleed burden for intracranial haemorrhage but this effect was less marked for ischaemic stroke (for five or more cerebral microbleeds, aHR 4·55 [95% CI 3·08-6·72] for intracranial haemorrhage vs 1·47 [1·19-1·80] for ischaemic stroke; for ten or more cerebral microbleeds, aHR 5·52 [3·36-9·05] vs 1·43 [1·07-1·91]; and for ≥20 cerebral microbleeds, aHR 8·61 [4·69-15·81] vs 1·86 [1·23-1·82]). However, irrespective of cerebral microbleed anatomical distribution or burden, the rate of ischaemic stroke exceeded that of intracranial haemorrhage (for ten or more cerebral microbleeds, 64 ischaemic strokes [95% CI 48-84] per 1000 patient-years vs 27 intracranial haemorrhages [17-41] per 1000 patient-years; and for ≥20 cerebral microbleeds, 73 ischaemic strokes [46-108] per 1000 patient-years vs 39 intracranial haemorrhages [21-67] per 1000 patient-years). In patients with recent ischaemic stroke or transient ischaemic attack, cerebral microbleeds are associated with a greater relative hazard (aHR) for subsequent intracranial haemorrhage than for ischaemic stroke, but the absolute risk of ischaemic stroke is higher than that of intracranial haemorrhage, regardless of cerebral microbleed presence, antomical distribution, or burden. British Heart Foundation and UK Stroke Association.en_US
dc.language.isoeng-
dc.titleCerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleThe Lancet. Neurologyen_US
dc.identifier.affiliationDepartment of Neurology and Stroke Centre, University Hospital Basel and University of Basel, Basel, Switzerlanden_US
dc.identifier.affiliationNeurology and Neurorehabilitation, University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerlanden_US
dc.identifier.affiliationLiverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UKen_US
dc.identifier.affiliationDepartment of Diagnostic and Interventional Neuroradiology and Department of Neurology Inselspital, University Hospital Bern, University of Bern, Bern, Switzerlanden_US
dc.identifier.affiliationUnit of Neuroradiology, Hospital Santa Creu i Sant Pau, Universitat Autonoma, Barcelona, Spainen_US
dc.identifier.affiliationCentre for Prevention of Stroke and Dementia, University of Oxford, Oxford, UKen_US
dc.identifier.affiliationDepartment of Neuroradiology, Sainte-Anne Hospital, Paris Descartes University, INSERM U1266, Paris, Franceen_US
dc.identifier.affiliationDepartment of Neurology, University Hospital of Würzburg, Josef-Schneider Strasse 11, Würzburg, Germanyen_US
dc.identifier.affiliationDepartment of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kongen_US
dc.identifier.affiliationDepartment of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kongen_US
dc.identifier.affiliationThe Neurovascular Research Unit and Health Research Board, Stroke Clinical Trials Network Ireland, University College Dublin, Dublin, Irelanden_US
dc.identifier.affiliationDepartment of Geriatric and Stroke Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland; Beaumont Hospital Dublin, Irelanden_US
dc.identifier.affiliationDepartment of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, Netherlandsen_US
dc.identifier.affiliationDepartment of Radiology and Nuclear Medicine, Erasmus Medical Centre, University Medical Centre, Rotterdam, Netherlandsen_US
dc.identifier.affiliationDepartment of Neurology, Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlandsen_US
dc.identifier.affiliationLucerne State Hospital; Switzerland Center for Neurology and Neurorehabilitation, Luzern, Switzerlanden_US
dc.identifier.affiliationDepartment of Neurology, National Neuroscience Institute, Singapore, Singaporeen_US
dc.identifier.affiliationUniversity of Lille, Inserm, CHU de Lille, Degenerative and vascular cognitive disorders U1171, Lille, Franceen_US
dc.identifier.affiliationDepartment of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlandsen_US
dc.identifier.affiliationDepartment of Neurology, CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht, Netherlandsen_US
dc.identifier.affiliationDepartment of Neurology, The 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Chinaen_US
dc.identifier.affiliationMemory Aging and Cognition Centre, National University Health System, Singapore, Singaporeen_US
dc.identifier.affiliationDepartment of Neurology, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlandsen_US
dc.identifier.affiliationAalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmarken_US
dc.identifier.affiliationDepartment of Neurology, Heidelberg University Hospital, Heidelberg, Germanyen_US
dc.identifier.affiliationNew Zealand Brain Research Institute, Christchurch, New Zealanden_US
dc.identifier.affiliationDepartment of Neurology, Seoul National University Bundang Hospital, Seoul National University School of Medicine, Seongnam, South Koreaen_US
dc.identifier.affiliationDepartment of Neurology, Hallym University Sacred Heart Hospital, Anyang, South Koreaen_US
dc.identifier.affiliationDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japanen_US
dc.identifier.affiliationAssistance Publique Hôpitaux de Paris, Lariboisière Hospital, Department of Neurology, Paris, France; Département Hospitalo-Universtaire NeuroVasc, University Paris Diderot, and INSERM U1141, Paris, Franceen_US
dc.identifier.affiliationDepartment of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germanyen_US
dc.identifier.affiliationDivision of Neurology, Department of Medicine, The University of Hong Kong, Hong Kongen_US
dc.identifier.affiliationDepartment of Diagnostic Radiology, The University of Hong Kong, Hong Kongen_US
dc.identifier.affiliationDepartment of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute, Barcelona, Spainen_US
dc.identifier.affiliationDepartment of Neurosurgery, Kushiro City General Hospital, Kushiro, Japanen_US
dc.identifier.affiliationDepartments of Neurology and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston MA, USAen_US
dc.identifier.affiliationTherese Pei Fong Chow Research Centre for Prevention of Dementia, Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kongen_US
dc.identifier.affiliationDepartment of Neurology, Yonsei University College of Medicine, Seoul, South Koreaen_US
dc.identifier.affiliationDepartment of Neurology, Ewha Womans University College of Medicine, Seoul, South Koreaen_US
dc.identifier.affiliationCenter for Brain and Disease Research, VIB, Leuven, Belgiumen_US
dc.identifier.affiliationExperimental Neurology and Leuven Institute for Neuroscience and Disease, Katholieke Universiteit Leuven, University of Leuven, Laboratory of Neurobiology, Leuven, Belgiumen_US
dc.identifier.affiliationDepartment of Neurology, Medical University of Graz, Graz, Austriaen_US
dc.identifier.affiliationDepartment of Neurology, Demiroglu Bilim University, Istanbul, Turkeyen_US
dc.identifier.affiliationDepartment of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israelen_US
dc.identifier.affiliationDivision of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Nabeshima, Saga, Japanen_US
dc.identifier.affiliationCalgary Stroke Program, Department of Clinical Neurosciences, Radiology and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canadaen_US
dc.identifier.affiliationDepartment of Neurology and Stroke Centre, University Hospital Basel and University of Basel, Basel, Switzerlanden_US
dc.identifier.affiliationJulius Centre for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands; Department of Neurology and Neurosurgery, Utrecht Stroke Centre, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlandsen_US
dc.identifier.affiliationDepartment of Neurology and Neurosurgery, Utrecht Stroke Centre, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlandsen_US
dc.identifier.affiliationDepartment of Diagnostic and Interventional Neuroradiology and Department of Neurology Inselspital, University Hospital Bern, University of Bern, Bern, Switzerlanden_US
dc.identifier.affiliationDepartment of Neurology, Sainte-Anne Hospital, Paris Descartes University, INSERM U1266, Paris, Franceen_US
dc.identifier.affiliationStroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australiaen_US
dc.identifier.affiliationDepartment of Neurosciences, University Hospitals Leuven, Belgiumen_US
dc.identifier.affiliationDepartment of Neurology, Austin Health, Heidelberg, Victoria, Australiaen_US
dc.identifier.affiliationStroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australiaen_US
dc.identifier.affiliationPeninsula Clinical School, Peninsula Health, Monash University, Melbourne, Victoria, Australiaen_US
dc.identifier.affiliationInstitute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UKen_US
dc.identifier.affiliationLysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, London, UKen_US
dc.identifier.affiliationCentre for Clinical Brain Sciences, School of Clinical Sciences, University of Edinburgh, Edinburgh, UKen_US
dc.identifier.affiliationDepartment of Statistical Science, University College London, London, UKen_US
dc.identifier.affiliationUK Dementia Institute at the University of Edinburgh, School of Clinical Sciences, University of Edinburgh, Edinburgh, UKen_US
dc.identifier.affiliationEdinburgh Imaging, School of Clinical Sciences, University of Edinburgh, Edinburgh, UKen_US
dc.identifier.affiliationDepartment of Stroke Medicine, Imperial College London, London, UKen_US
dc.identifier.affiliationComprehensive Stroke Service, University College London Hospitals NHS Trust, London, UKen_US
dc.identifier.affiliationNational Hospital for Neurology and Neurosurgery, London UKen_US
dc.identifier.affiliationStroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UKen_US
dc.identifier.doi10.1016/S1474-4422(19)30197-8en_US
dc.type.contentTexten_US
dc.identifier.orcid0000-0002-6614-8417en_US
dc.identifier.pubmedid31130428-
dc.type.austinJournal Article-
local.name.researcherThijs, Vincent N
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.languageiso639-1en-
item.openairetypeJournal Article-
crisitem.author.deptNeurology-
crisitem.author.deptThe Florey Institute of Neuroscience and Mental Health-
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