Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Natural Course of Moyamoya Disease in Patients With Prior Hemorrhagic Stroke
First author：Kang Shuai,Liu Xingju
Corresponding author：Zhang Dong ,Zhao Ji-Zong
essential_information
- Person in charge：Kang Shuai,Liu Xingju
- Data Sources： OTHERS
- Number of papers：OTHERS20190779
- Published time：2019-05-01
2019-05-01
Published articles
Journal：Stroke
Publication type: Original Contribution
IF(IF): 7.914
PMID: 30909836 Link To Pubmed Full text Download
Background And Purpose
Method
A total of 128 conservatively managed patients with hemorrhagic presentation and complete follow-up data were included. Recurrent hemorrhages during long-term follow-up were documented. Annual and cumulative incidence rate of bleeding was generated via Kaplan-Meier survival analysis, and risk factors were analyzed using logistic regression analysis.
Conclusion
Rebleeding events were common and the main cause of death in patients with hemorrhagic moyamoya disease. The risk of rebleeding steadily increased during long-term follow-up. Smoking was a risk factor for rebleeding, and hypertension was associated with increased mortality.
Main results
The median follow-up time was 10.1 (1-27) years. During a total of 1300.7 patient-years, 47 (36.7%) patients experienced 59 occurrences of recurrent hemorrhages, rendering an average annual incidence of 4.5%. Among them, 9 patients (19.1%) died from rebleeding and 12 patients sustained severe disability (modified Rankin Scale score of ≥3). The cumulative risk of rebleeding was 7.8% at 5 years, 22.6% at 10 years, and 35.9% at 15 years. Only 4 (3.1%) patients experienced ischemic stroke, yielding an average annual incidence of 0.3%. Multivariate analysis showed that smoking (odds ratio, 4.85; P=0.04) was an independent risk factor of rebleeding. Rebleeding (hazard ratio, 11.04; P=0.02) and hypertension (hazard ratio, 4.16; P=0.04) were associated with increased mortality. Age, type of initial bleeding, digital subtraction angiography staging, family history, and coexisting cerebral aneurysms were not associated with increased risk of rebleeding.