Risk Factors for Growth of Unruptured Intracranial Aneurysms: Follow-up Study by Serial 0.5–T Magnetic Resonance Angiography

Neurosurgery ◽  
2006 ◽  
Vol 58 (6) ◽  
pp. 1047-1053 ◽  
Author(s):  
Nobuhiko Miyazawa ◽  
Iwao Akiyama ◽  
Zentaro Yamagata
Keyword(s):  
Risk Factors ◽  
Subarachnoid Hemorrhage ◽  
Family History ◽  
Unruptured Aneurysms ◽  
Logistic Analysis ◽  
Aneurysm Size ◽  
History Of ◽  
Aneurysm Growth ◽  
Independent Risk Factors

Abstract OBJECTIVE: The independent risk factors for aneurysm growth were retrospectively investigated in 130 patients with unruptured aneurysms who were followed up by 0.5–T serial magnetic resonance angiography with stereoscopic images. METHODS: Age, sex, site of aneurysm, size of aneurysm, multiplicity of aneurysms, type of circle of Willis, length of follow-up period, cerebrovascular event, hypertension, diabetes, hyperlipidemia, smoking habit, and family history of subarachnoid hemorrhage were investigated using multiple logistic analysis. RESULTS: Fourteen patients (16 aneurysms) among the 130 patients (159 aneurysms) showed aneurysm growth (10.8%) during follow-up of 10 to 69 months (mean 29.3 ± 10.5 mo). Multiple logistic analysis disclosed that location on the middle cerebral artery (odds ratio [OR] 0.08, P < 0.01), multiplicity of aneurysms (OR 68.5, P < 0.01), aneurysm size of 5 mm or larger (OR 1.17, P = 0.05), and family history of subarachnoid hemorrhage (OR 10.9, P < 0.01) were independent risk factors. CONCLUSION: Location on the middle cerebral artery, multiplicity, aneurysm size of 5 mm or larger, and family history of subarachnoid hemorrhage are independent risk factors for aneurysm growth. These results may help to determine the treatment choice for unruptured aneurysms.

scholarly journals Factors Affecting the Outcome of Multiple Intracranial Aneurysm Surgery

2018 ◽  
Vol 07 (02) ◽  
pp. 116-121 ◽  
Author(s):  
Anas Abdallah ◽  
Murad Asiltürk ◽  
Erhan Emel ◽  
Betül Güler Abdallah
Keyword(s):  
Risk Factors ◽  
Surgical Outcomes ◽  
Medical Records ◽  
Core Sample ◽  
Morbidity Rate ◽  
Factors Affecting ◽  
Unruptured Aneurysms ◽  
History Of ◽  
Independent Risk Factors

Abstract Objectives Multiple intracranial aneurysms (MIAs) are fairly common entities. Unless MIAs are incidentally diagnosed, they remain asymptomatic until they rupture. In this study, the authors investigated factors affecting the surgical outcomes in patients with MIA by evaluating the surgical outcomes of 90 consecutive cases. Material and Methods Medical records were retrospectively reviewed for 409 consecutive cerebral aneurysm cases that underwent surgery in the hospital from 2011 to 2013. The patients’ data were prospectively collected. All MIA patients (n = 90) constituted the core sample for this study. Results The authors detected 221 aneurysms in 90 patients (49 females and 41 males; mean age: 50.8 ± 11.9 years; range: 25–82 years). Of the patients, 67 presented with subarachnoid hemorrhage, whereas 23 were incidentally diagnosed with unruptured aneurysms. The mortality rate was 13.3% (n = 12). The morbidity rate was 18.8% (n = 17). Of the patients, 67.8% (n = 61) had returned to their jobs and normal daily activities by their last follow-up (average: 52.3 months). History of coronary artery diseases (CADs) and low neurologic grade at presentation (Hunt-Hess grade 4/5) are independent risk factors for increasing morbidity and mortality in patients with MIA (odds ratio [OR]: 18.46; p = 0.007); (OR: 30.0; p = 0.002) and (OR: 0.06; p = 0.0001); (OR: 0.07; p = 0.002), respectively. Conclusion History of CADs and high Hunt-Hess grade are independent risk factors for poor surgical outcomes of patients with MIA.

Enlargement of small, asymptomatic, unruptured intracranial aneurysms in patients with no history of subarachnoid hemorrhage: the different factors related to the growth of single and multiple aneurysms

2013 ◽  
Vol 119 (1) ◽  
pp. 190-197 ◽  
Author(s):  
Aichi Chien ◽  
Feng Liang ◽  
James Sayre ◽  
Noriko Salamon ◽  
Pablo Villablanca ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intracranial Aneurysms ◽  
Posterior Circulation ◽  
Unruptured Aneurysms ◽  
Multiple Aneurysms ◽  
Unruptured Intracranial Aneurysms ◽  
History Of ◽  
Aneurysm Growth ◽  
Small Aneurysms

Object This study was performed to investigate the risk factors related to the growth of small, asymptomatic, unruptured aneurysms in patients with no history of subarachnoid hemorrhage (SAH). Methods Between January 2005 and December 2010, a total of 508 patients in whom unruptured intracranial aneurysms were diagnosed at the University of California, Los Angeles medical center did not receive treatment to prevent rupture. Of these, 235 patients with no history of SAH who had asymptomatic, small, unruptured aneurysms (< 7 mm) were monitored with 3D CT angiography images. Follow-up images of the lesions were used to measure aneurysm size changes. Patient medical history, family history of SAH, aneurysm size, and location were studied to find the risk factors associated with small aneurysm growth. Results A total of 319 small aneurysms were included, with follow-up durations of 29.2 ± 20.6 months. Forty-two aneurysms increased in size during the follow-up; 5 aneurysms grew to become ≥ 7 mm within 38.2 ± 18.3 months. A trend of higher growth rates was found in single aneurysms than in multiple aneurysms (p = 0.07). A history of stroke was the only factor associated with single aneurysm growth (p = 0.03). The number of aneurysms (p = 0.011), number of aneurysms located within the posterior circulation (p = 0.030), and patient history of transient ischemic attack (p = 0.044) were related to multiple aneurysm growth. Conclusions Multiple small aneurysms are more likely to grow, and multiple aneurysms located in the posterior circulation may require additional attention. Although single aneurysms have a lower risk of growth, a trend of higher growth rates in single aneurysms was found.

scholarly journals Cardiovascular family history increases the risk of disease recurrence after a first myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Wahrenberg ◽  
P Magnusson ◽  
R Kuja-Halkola ◽  
H Habel ◽  
K Hambraeus ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Family History ◽  
Cardiovascular Events ◽  
Cardiovascular Death ◽  
Funding Source ◽  
History Of ◽  
First Time ◽  
Early Family

Abstract Background Despite recent advances in secondary prevention, recurrent cardiovascular events are common after a myocardial infarction (MI). It has been reported that genetic risk scores may predict the risk of recurrent cardiovascular events. Although patient-derived family history is a composite of both genetic and environmental heritability of atherosclerotic cardiovascular disease (ASCVD), it is an easily accessible information compared to genetically based risk models but the association with recurrent events is unknown. Purpose To evaluate whether a register-verified family history of ASCVD is associated with recurrent cardiovascular events (rASCVD) in patients after a first-time MI. Methods We included patients with a first-time MI during 2005 – 2014, registered in the SWEDEHEART SEPHIA registry and without prior ASCVD. Follow-up was available until Dec 31st, 2018. Data on relatives, diagnoses and prescriptions were extracted from national registers. A family history of ASCVD was defined as a register-verified hospitalisation due to MI, angina with coronary revascularization procedures, stroke or cardiovascular death in any parent. Early history was defined as such an event before the age of 55 years in fathers and 65 years in mothers. The association between family history and a composite outcome including recurrent MI, angina requiring acute revascularization, ischaemic stroke and cardiovascular death during follow-up was studied with Cox proportional hazard regression with time from SEPHIA registry completion as underlying time-scale, adjusted for age with splines, gender and year of SEPHIA registry. Regression models were then further adjusted for hypertension, diabetes, smoking and for a subset of patients, LDL-cholesterol (LDL_C) at time of first event. Results Of 25,615 patients, 2.5% and 32.1% had an early and ever-occurring family history of ASCVD, respectively. Patients with early family history were significantly younger than other patients and were more likely to be current smokers and have a higher LDL-C (Median (IQR) 3.5 (1.1) vs 3.3 (1.1) mmol/L). In total, 3,971 (15.5%) patients experienced the outcome. Early family history of ASCVD was significantly associated with rASCVD (Hazard ratio (HR) 1.52, 95% confidence interval (CI) 1.23–1.87), and the effect was sustained when adjusted for cardiovascular risk factors (HR 1.48, 95% CI 1.20–1.83) and LDL-C (HR 1.35, 95% CI 1.04–1.74). Ever-occurring family history was weakly associated with ASCVD (HR 1.09, 95% CI 1.02 – 1.17) and the association remained unchanged with adjustments for risk factors. Conclusions Early family history of cardiovascular disease is a potent risk factor for recurrent cardiovascular events in a secondary prevention setting, independent of traditional risk factors including LDL-C. This is a novel finding and these patients may potentially benefit from intensified secondary preventive measures after a first-time MI. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): This work was funded by grants from The Swedish Heart and Lung Association

scholarly journals Risk factors for a first thrombotic event in antiphospholipid antibody carriers: a prospective multicentre follow-up study

2011 ◽  
Vol 70 (6) ◽  
pp. 1083-1086 ◽  
Author(s):  
Amelia Ruffatti ◽  
Teresa Del Ross ◽  
Manuela Ciprian ◽  
Maria T Bertero ◽  
Sciascia Salvatore ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Univariate Analysis ◽  
Thrombotic Event ◽  
Multivariate Logistic Regression Analysis ◽  
Antiphospholipid Antibody ◽  
History Of ◽  
Ischaemic Attack ◽  
Independent Risk Factors

ObjectivesTo assess risk factors for a first thrombotic event in confirmed antiphospholipid (aPL) antibody carriers and to evaluate the efficacy of prophylactic treatments.MethodsInclusion criteria were age 18–65 years, no history of thrombosis and two consecutive positive aPL results. Demographic, laboratory and clinical parameters were collected at enrolment, once a year during the follow-up and at the time of the thrombotic event, whenever that occurred.Results258 subjects were prospectively observed between October 2004 and October 2008. The mean±SD follow-up was 35.0±11.9 months (range 1–48). A first thrombotic event (9 venous, 4 arterial and 1 transient ischaemic attack) occurred in 14 subjects (5.4%, annual incidence rate 1.86%). Hypertension and lupus anticoagulant (LA) were significantly predictive of thrombosis (both at p<0.05) and thromboprophylaxis was significantly protective during high-risk periods (p<0.05) according to univariate analysis. Hypertension and LA were identified by multivariate logistic regression analysis as independent risk factors for thrombosis (HR 3.8, 95% CI 1.3 to 11.1, p<0.05, and HR 3.9, 95% CI 1.1 to 14, p<0.05, respectively).ConclusionsHypertension and LA are independent risk factors for thrombosis in aPL carriers. Thromboprophylaxis in these subjects should probably be limited to high-risk situations.

Natural history of unruptured intracranial aneurysms: probability of and risk factors for aneurysm rupture

2008 ◽  
Vol 108 (5) ◽  
pp. 1052-1060 ◽  
Author(s):  
Seppo Juvela ◽  
Matti Porras ◽  
Kristiina Poussa
Keyword(s):  
Risk Factors ◽  
Intracranial Aneurysms ◽  
Smoking Status ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Aneurysm Rupture ◽  
Unruptured Aneurysms ◽  
Unruptured Intracranial Aneurysms ◽  
History Of

Object The authors conducted a study to investigate the long-term natural history of unruptured intracranial aneurysms and the predictive risk factors determining subsequent rupture in a patient population in which surgical selection of cases was not performed. Methods One hundred forty-two patients with 181 unruptured aneurysms were followed from the 1950s until death or the occurrence of subarachnoid hemorrhage or until the years 1997 to 1998. The annual and cumulative incidence of aneurysm rupture as well as several potential risk factors predictive of rupture were studied using life-table analyses and Cox's proportional hazards regression models including time-dependent covariates. The median follow-up time was 19.7 years (range 0.8–38.9 years). During 2575 person-years of follow up, there were 33 first-time episodes of hemorrhage from previously unruptured aneurysms, for an average annual incidence of 1.3%. In 17 patients, hemorrhage led to death. The cumulative rate of bleeding was 10.5% at 10 years, 23% at 20 years, and 30.3% at 30 years after diagnosis. The diameter of the unruptured aneurysm (relative risk [RR] 1.11 per mm in diameter, 95% confidence interval [CI] 1–1.23, p = 0.05) and patient age at diagnosis inversely (RR 0.97 per year, 95% CI 0.93–1, p = 0.05) were significant independent predictors for a subsequent aneurysm rupture after adjustment for sex, hypertension, and aneurysm group. Active smoking status at the time of diagnosis was a significant risk factor for aneurysm rupture (RR 1.46, 95% CI 1.04–2.06, p = 0.033) after adjustment for size of the aneurysm, patient age, sex, presence of hypertension, and aneurysm group. Active smoking status as a time-dependent covariate was an even more significant risk factor for aneurysm rupture (adjusted RR 3.04, 95% CI 1.21–7.66, p = 0.02). Conclusions Cigarette smoking, size of the unruptured intracranial aneurysm, and age, inversely, are important factors determining risk for subsequent aneurysm rupture. The authors conclude that such unruptured aneurysms should be surgically treated regardless of their size and of a patient's smoking status, especially in young and middle-aged adults, if this is technically possible and if the patient's concurrent diseases are not contraindications. Cessation of smoking may also be a good alternative to surgery in older patients with small-sized aneurysms.

Risk factors for a first thrombotic event in antiphospholipid antibody carriers. A multicentre, retrospective follow-up study

2008 ◽  
Vol 68 (3) ◽  
pp. 397-399 ◽  
Author(s):  
A Ruffatti ◽  
T Del Ross ◽  
M Ciprian ◽  
M Nuzzo ◽  
M Rampudda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Thrombotic Event ◽  
Multivariate Logistic Regression Analysis ◽  
Anticardiolipin Antibody ◽  
Primary Prophylaxis ◽  
Antiphospholipid Antibody ◽  
History Of ◽  
Independent Risk Factors

Objectives:To asses risk factors for a first thrombotic event in antiphospholipid antibody (aPL) positive carriers and evaluate the efficacy of prophylactic treatments.Methods:Recruitment criteria were age 18–65 years, no history of thrombosis, positivity for lupus anticoagulant and/or IgG/IgM anticardiolipin antibody (aCL) on ⩾2 occasions at least 6 weeks apart. Demographic, laboratory and clinical parameters were collected at enrolment and at the time of the thrombotic event.Results:370 patients/subjects (mean (SD) age 34 (9.9) years) were analysed retrospectively for a mean (SD) follow-up of 59.3 (45.5) months. Thirty patients (8.1%) developed a first thrombotic event during follow-up. Hypertension and medium/high levels of IgG aCL were identified by multivariate logistic regression analysis as independent risk factors for thrombosis. Thromboprophylaxis during high-risk and long-term periods was significantly protective.Conclusions:Hypertension or medium/high titres of IgG aCL are risk factors for a first thrombotic event in asymptomatic aPL carriers and primary prophylaxis is protective.

scholarly journals Risk Factors for Early Recurrence of Gallstones in Patients Undergoing Laparoscopy Combined With Choledochoscopic Lithotomy: A Single-Center Prospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Bo Wang ◽  
Anhua Huang ◽  
Min Jiang ◽  
Haidong Li ◽  
Wenqing Bao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Prospective Study ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Gallbladder Wall ◽  
Postoperative Recurrence ◽  
Factors Associated ◽  
History Of

Objective: For patients with gallstones, laparoscopy combined with choledochoscopic lithotomy is a therapeutic surgical option for preservation rather than the removal of the gallbladder. However, postoperative recurrence of gallstones is a key concern for both patients and surgeons. This prospective study was performed to investigate the risk factors for early postoperative recurrence of gallstones.Methods: The clinical data of 466 patients were collected. Each patient was followed up for up to 2 years. The first follow-up visit occurred 4 months after the operation, and a follow-up visit was carried out every 6 months thereafter. The main goal of each visit was to confirm the presence or absence of gallbladder stones. The factors associated with gallstone recurrence were analyzed by univariate analysis and Cox regression.Results: In total, 466 eligible patients were included in the study, and 438 patients (180 men and 258 women) completed the 2-year postoperative follow-up. The follow-up rate was 94.0%. Recurrence of gallstones was detected in 5.71% (25/438) of the patients. Univariate analysis revealed five risk factors for the recurrence of gallstones. Multivariate Cox regression analysis showed that multiple gallstones, a gallbladder wall thickness of ≥4 mm, and a family history of gallbladder stones were the three predictive factors for postoperative recurrence of gallstones (P &lt; 0.05).Conclusion: The overall 2-year recurrence rate of gallstones after the operation was 5.71%. Multiple gallstones, a gallbladder wall thickness of ≥4 mm, and a family history of gallstones were the three risk factors associated with early postoperative recurrence of gallstones.

scholarly journals The related risk factors of diabetic retinopathy in elderly patients with Type 2 diabetes mellitus: A cohort study

2020 ◽  
Author(s):  
Ying-Chu Chiu ◽  
Tien-Lung Tsai ◽  
Meiyin Su ◽  
Tsan Yang ◽  
Peng-Lin Tseng ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Family History ◽  
Elderly Patients ◽  
Betel Nut ◽  
Family History Of Diabetes ◽  
Related Risk ◽  
History Of

Abstract Background: Diabetic retinopathy (DR) caused by small vessel disease was the main cause of blindness in person with diabetes, and it mainly occurred in patients with Type 2 diabetes mellitus (T2DM). Taiwan was one of the Asian countries with the highest prevalence rate of DR, there were only few studies for the risk of DR in patients with T2DM in Taiwan. According to some studies have shown DR was a major cause of blindness on elderly both in developed and other developing countries. The purpose was to investigate the related risk factors of DR in elderly patients with T2DM. Methods: During July 2010 to December 2017, 4010 T2DM patients without DR were preselected for this study, but 792 patients completed the continuously follow-up evaluation. Patients were invited to have an outpatient visit at least every three months, and they were asked to fill out a brief questionnaire and collect their blood samples. Additionally, statistical methods used independent sample T-test, Chi-square tests and logistic regression in univariate analysis to analyze the relationships between onset DR and each related factor; and finally the optimal multivariate logistic regression model would be determined by stepwise model selection. Results: Of the 792 effective samples, 611 patients (77.1%) progressed to DR and 181 patients (22.9%) did not get DR during the follow-up period. According to the results, the significant factors were women (OR, 2.20; 95%CI, 1.52-3.17), longer diabetic duration (OR, 1.05; 95% CI, 1.03-1.08), family history of diabetes (OR, 1.55; 95% CI: 1.09-2.21), higher concentration glycated hemoglobin (HbA1c) (OR, 1.27; 95% CI: 1.12-1.44), higher mean low density lipoprotein cholesterol (LDL-c) (OR, 1.01; 95% CI: 1.00-1.01), and chewing betel nut (OR, 2.85; 95% CI: 1.41-5.77). Conclusions: This prospective cohort study showed that gender, behavior of chewing betel nut, diabetic duration, family history of diabetes, HbA1c, and LDL-c, were important factors for the development of DR in elderly patients with T2DM. It suggested that those patients should well control their HbA1c and LDL-c and quit chewing betel nut to prevent from DR, especially for female patients with family history of diabetes and longer duration of diabetes.

Abstract 14539: Incidence, Risk Factors, Natural History, and Outcomes of Atrial Fibrillation in Patients With Graves’ Disease

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jwan A Naser ◽  
Sorin Pislaru ◽  
Marius N Stan ◽  
Grace Lin
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Major Cardiovascular Events ◽  
Multivariate Risk ◽  
Incidence Risk ◽  
History Of ◽  
Independent Risk Factors ◽  
Artery Disease ◽  
Overt Hyperthyroidism

Background: Hyperthyroidism is associated with atrial fibrillation (AF) with a reported prevalence of 16-60%. However, risk factors for onset of AF with hyperthyroidism are not well defined. We sought to identify patients with hyperthyroidism most likely to develop AF. Methods: We reviewed the medical records of 1371 consecutive patients with GD evaluated at our clinic between 2009 and 2019. GD-related AF was defined as AF diagnosed up to 30 days before or at any time after Grave’s disease (GD). Spontaneous recovery was defined as sinus rhythm after attainment of euthyroidism without the need for pharmacologic or electrical cardioversion. Outcomes of major cardiovascular events, all-cause mortality, and cardiac hospitalizations were compared between cases and controls (GD without AF) matched 1:1 for age, gender, and history of coronary artery disease. Results: AF occurred in 140 patients with an incidence of 10.2%. Older age (RR 1.63 per 10 years, p <0.001), male gender (RR 2.06, p < 0.001), overt hyperthyroidism (RR 2.48, p = 0.002), COPD (RR 2.14, p =0.006), and higher BMI (RR 1.03 per unit, p=0.023) were independent risk factors for AF. Spontaneous AF recovery occurred in 44 of 128 (34.6%) patients with adequate follow up. The multivariate risk factor for failed recovery was the presence of heart failure (HF) (OR =3.52, p= 0.004). GD patients with AF had higher rates of cardiac hospitalizations (Figure) that persisted even after adjusting to HF presence (27.9% vs 2.9%, p < 0.001). Conclusion: Risk factors for AF in GD are similar to those in the general population, although overt hyperthyroidism conferred the highest risk. These data argue for careful monitoring of GD patients with multimorbidity who may be at high risk of developing AF.

ELAPSS score for prediction of risk of growth of unruptured intracranial aneurysms

Neurology ◽  
2017 ◽  
Vol 88 (17) ◽  
pp. 1600-1606 ◽  
Author(s):  
Daan Backes ◽  
Gabriel J.E. Rinkel ◽  
Jacoba P. Greving ◽  
Birgitta K. Velthuis ◽  
Yuichi Murayama ◽  
...  
Keyword(s):  
Risk Factor ◽  
Subarachnoid Hemorrhage ◽  
Risk Score ◽  
Intracranial Aneurysms ◽  
Cox Regression Analysis ◽  
Unruptured Intracranial Aneurysms ◽  
History Of ◽  
Aneurysm Growth ◽  
Risk Factor Status

Objective:To develop a risk score that estimates 3-year and 5-year absolute risks for aneurysm growth.Methods:From 10 cohorts of patients with unruptured intracranial aneurysms and follow-up imaging, we pooled individual data on sex, population, age, hypertension, history of subarachnoid hemorrhage, and aneurysm location, size, aspect ratio, and shape but not on smoking during follow-up and family history of intracranial aneurysms in 1,507 patients with 1,909 unruptured intracranial aneurysms and used aneurysm growth as outcome. With aneurysm-based multivariable Cox regression analysis, we determined predictors for aneurysm growth, which were presented as a risk score to calculate 3-year and 5-year risks for aneurysm growth by risk factor status.Results:Aneurysm growth occurred in 257 patients (17%) and 267 aneurysms (14%) during 5,782 patient-years of follow-up. Predictors for aneurysm growth were earlier subarachnoid hemorrhage, location of the aneurysm, age >60 years, population, size of the aneurysm, and shape of the aneurysm (ELAPSS). The 3-year growth risk ranged from <5% to >42% and the 5-year growth risk from <9% to >60%, depending on the risk factor status.Conclusions:The ELAPSS score consists of 6 easily retrievable predictors and can help physicians in decision making on the need for and timing of follow-up imaging in patients with unruptured intracranial aneurysms.

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