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Abstract Details

Long-term Trajectories in Framingham Stroke Risk Profile and Risk of Stroke and Post-stroke Dementia: The Framingham Heart Study
Cerebrovascular Disease and Interventional Neurology
S31 - Stroke Risk Factors, Outcomes, and Prevention (4:42 PM-4:54 PM)
007

To evaluate the association of long-term Framingham Stroke Risk Profile (FSRP) trajectories with incident stroke or transient ischemic attack (TIA) and post-stroke incident dementia (PSD) in a community-dwelling population.

Cross-sectional FSRP assessments predict 10-year probability of incident stroke. Whether long-term trajectory of FSRP score better reflects the risk of stroke and PSD is unclear.

Stroke- and dementia-free Framingham Heart Study Original and Offspring Cohort participants with at least 9 and 4 FSRP observations, respectively, were included. FSRP trajectories over age were analyzed using functional principal component (FPC) analysis, followed by K-means clustering of FPC scores. Cox proportional hazards regression was performed with the FPC scores and clusters as main exposures in models adjusted for age, FSRP (at first FSRP observation for stroke/TIA and at stroke/TIA for PSD), sex, and cohort.

FPC analysis identified 2 major modes of variation in FSRP trajectories of 6,142 participants, where the first FPC explained 90% of variance, and the second an additional 9%. 945 (15.4%) had incident stroke/TIA over mean follow-up 31.9 years (SD 9.2). Increased FPC1 score was associated with increased stroke/TIA risk (HR 1.54, 95%CI 1.39-1.69) while increased FPC2 score was associated with decreased risk (HR 0.25, 95%CI 0.17-0.39). K-means clustering identified 2 groups: cluster 1 (n=5,554) had 14.0% stroke/TIA incidence versus 28.1% in cluster 2 (n=588). Cluster 2 was associated with higher stroke/TIA risk (HR 1.54, 95%CI 1.30-1.83). Among 756 dementia-free stroke/TIA survivors, 141 (18.7%) developed dementia over mean follow-up 6.0 years (SD 6.2), with a greater proportion in cluster 2 (27/129, 20.9%) versus cluster 1 (114/627, 18.2%). However, cluster 2 was not associated with PSD after adjusting for FSRP at stroke/TIA (HR 0.77, 95% CI 0.46-1.29).

 

Long-term FSRP trajectory was associated with risk of incident stroke/TIA but not PSD. Our findings support consideration of longitudinal FSRP trajectory to assess stroke risk.
Authors/Disclosures
Aksel Laudon, BS
PRESENTER 		Mr. Laudon has nothing to disclose.
Xinrui Shi, MS Miss Shi has nothing to disclose.
Hugo Javier Aparicio, MD, MPH (Boston University) Dr. Aparicio has received research support from 好色先生. Dr. Aparicio has received research support from Alzheimer's Association. Dr. Aparicio has received research support from National Institutes of Health. Dr. Aparicio has received personal compensation in the range of $10,000-$49,999 for serving as a expert panelist for the Memory & Healthy Aging Program with Cedars-Sinai.
Vasileios-Arsenios Lioutas, MD (Beth Israel Deaconess Medical Center, Department of Neurology) Dr. Lioutas has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Qmetis. Dr. Lioutas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mindray. The institution of Dr. Lioutas has received research support from NIH. The institution of Dr. Lioutas has received research support from Alzheimer's Association.
Oluchi S. Ekenze Ms. Ekenze has nothing to disclose.
Virginia J. Howard, PhD (University of Alabama At Birmingham) The institution of Dr. Howard has received research support from NIH. The institution of an immediate family member of Dr. Howard has received research support from NIH.
Myriam Fornage Myriam Fornage has nothing to disclose.
Sudha Seshadri, MD, FAAN (Glenn Biggs Institute for Alzheimer'S and Neurodegenerative Diseases) Dr. Seshadri has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Seshadri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. The institution of Dr. Seshadri has received research support from NIH. The institution of Dr. Seshadri has received research support from Alzheimer Association.
Alexa Beiser Alexa Beiser has nothing to disclose.
Qiong Yang Qiong Yang has nothing to disclose.
Jose R. Romero, MD (Boston University School of Medicine - Boston Medical Center) The institution of Dr. Romero has received research support from NIH/NIA.