Risk Factors for Lobar and Non-Lobar Intracerebral Hemorrhage in Patients with Vascular Disease

Lobar and non-lobar non-traumatic intracerebral hemorrhage (ICH) are presumably caused by different types of small vessel diseases. The aim of this study was to assess risk factors for ICH according to location. In two large prospective studies, SMART (n = 9088) and ESPRIT (n = 2625), including pati...

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Published in:PloS one 2015-11, Vol.10 (11), p.e0142338-e0142338
Main Authors: Kremer, Philip H C, Jolink, Wilmar M T, Kappelle, L Jaap, Algra, Ale, Klijn, Catharina J M
Format: Article
Language:English
Subjects:
Anticoagulants
Anticoagulants - therapeutic use
Cardiovascular diseases
Cerebral Hemorrhage - etiology
Cerebrovascular system
Diabetes
Drugs
Female
Hazards
Health risks
Hemorrhage
Humans
Incidence
Male
Middle Aged
Patients
Prospective Studies
Risk analysis
Risk Factors
Stroke
Studies
Vascular diseases
Vascular Diseases - complications
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Summary:Lobar and non-lobar non-traumatic intracerebral hemorrhage (ICH) are presumably caused by different types of small vessel diseases. The aim of this study was to assess risk factors for ICH according to location. In two large prospective studies, SMART (n = 9088) and ESPRIT (n = 2625), including patients with manifest cardiovascular, cerebrovascular or peripheral artery disease or with vascular risk factors, we investigated potential risk factors for ICH during follow-up according to lobar or non-lobar location by Cox proportional hazards analyses. During 65,156 patient years of follow up 19 patients had lobar ICH (incidence rate 29, 95% CI 19-42 per 100,000 person-years) and 24 non-lobar ICH (incidence rate 37, 95% CI 26-51 per 100,000 person-years). Age significantly increased the risk of lobar ICH (HR per 10 years increase 1.90; 95% CI 1.17-3.10) in the multivariable analysis, but not of non-lobar hemorrhage. Anticoagulant medication (HR 3.49; 95% CI 1.20-10.2) and male sex (HR 3.79; 95% CI 1.13-12.8) increased the risk of non-lobar but not lobar ICH. This study shows an elevated risk of future ICH in patients with manifestations of, or risk factors for, cardiovascular, cerebrovascular or peripheral artery disease. Our data suggest that risk factors for ICH vary according to location, supporting the hypothesis of a differential pathophysiology of lobar and non-lobar ICH.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0142338