Silent infarction as a risk factor for overt stroke in children with sickle cell anemia: A report from the Cooperative Study of Sickle Cell Disease

Scott T. Miller, Eric A. Macklin, Charles H. Pegelow, Thomas R. Kinney, Lynn A. Sleeper, Jacqueline A. Bello, L. Dana DeWitt, Dianne M. Gallagher, Ludovico Guarini, Franklin G. Moser, Kwaku Ohene-Frempong, Nelson Sanchez, Elliott P. Vichinsky, Winfred C. Wang, Doris L. Wethers, Donald P. Younkin, Robert A. Zimmerman, Michael R. DeBaun

Research output: Contribution to journalArticle

215 Citations (Scopus)

Abstract

Objective: To determine whether children with homozygous sickle cell anemia (SCD) who have silent infarcts on magnetic resonance imaging (MRI) of the brain are at increased risk for overt stroke. Methods: We selected patients with homozygous SCD who (1) enrolled in the Cooperative Study of Sickle Cell Disease (CSSCD) before age 6 months, (2) had at least 1 study-mandated brain MRI at age 6 years or older, and (3) had no overt stroke before a first MRI. MRI results and clinical and laboratory parameters were tested as predictors of stroke. Results: Among 248 eligible patients, mean age at first MRI was 8.3 ± 1.9 years, and mean follow-up after baseline MRI was 5.2 ± 2.2 years. Five (8.1%) of 62 patients with silent infarct had strokes compared with 1 (0.5%) of 186 patients without prior silent infarct; incidence per 100 patient-years of follow-up was increased 14-fold (1.45 per 100 patient-years vs 0.11 per 100 patient-years, P = .006). Of several clinical and laboratory parameters examined, silent infarct was the strongest independent predictor of stroke (hazard ratio = 7.2, P = .027). Conclusions: Silent infarct identified at age 6 years or older is associated with increased stroke risk.

Original languageEnglish (US)
Pages (from-to)385-390
Number of pages6
JournalJournal of Pediatrics
Volume139
Issue number3
DOIs
StatePublished - 2001

Fingerprint

Sickle Cell Anemia
Infarction
Stroke
Magnetic Resonance Imaging
Brain
Incidence

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Silent infarction as a risk factor for overt stroke in children with sickle cell anemia : A report from the Cooperative Study of Sickle Cell Disease. / Miller, Scott T.; Macklin, Eric A.; Pegelow, Charles H.; Kinney, Thomas R.; Sleeper, Lynn A.; Bello, Jacqueline A.; DeWitt, L. Dana; Gallagher, Dianne M.; Guarini, Ludovico; Moser, Franklin G.; Ohene-Frempong, Kwaku; Sanchez, Nelson; Vichinsky, Elliott P.; Wang, Winfred C.; Wethers, Doris L.; Younkin, Donald P.; Zimmerman, Robert A.; DeBaun, Michael R.

In: Journal of Pediatrics, Vol. 139, No. 3, 2001, p. 385-390.

Research output: Contribution to journalArticle

Miller, ST, Macklin, EA, Pegelow, CH, Kinney, TR, Sleeper, LA, Bello, JA, DeWitt, LD, Gallagher, DM, Guarini, L, Moser, FG, Ohene-Frempong, K, Sanchez, N, Vichinsky, EP, Wang, WC, Wethers, DL, Younkin, DP, Zimmerman, RA & DeBaun, MR 2001, 'Silent infarction as a risk factor for overt stroke in children with sickle cell anemia: A report from the Cooperative Study of Sickle Cell Disease', Journal of Pediatrics, vol. 139, no. 3, pp. 385-390. https://doi.org/10.1067/mpd.2001.117580
Miller, Scott T. ; Macklin, Eric A. ; Pegelow, Charles H. ; Kinney, Thomas R. ; Sleeper, Lynn A. ; Bello, Jacqueline A. ; DeWitt, L. Dana ; Gallagher, Dianne M. ; Guarini, Ludovico ; Moser, Franklin G. ; Ohene-Frempong, Kwaku ; Sanchez, Nelson ; Vichinsky, Elliott P. ; Wang, Winfred C. ; Wethers, Doris L. ; Younkin, Donald P. ; Zimmerman, Robert A. ; DeBaun, Michael R. / Silent infarction as a risk factor for overt stroke in children with sickle cell anemia : A report from the Cooperative Study of Sickle Cell Disease. In: Journal of Pediatrics. 2001 ; Vol. 139, No. 3. pp. 385-390.
@article{e73248e313b34db7a92bd3733034364a,
title = "Silent infarction as a risk factor for overt stroke in children with sickle cell anemia: A report from the Cooperative Study of Sickle Cell Disease",
abstract = "Objective: To determine whether children with homozygous sickle cell anemia (SCD) who have silent infarcts on magnetic resonance imaging (MRI) of the brain are at increased risk for overt stroke. Methods: We selected patients with homozygous SCD who (1) enrolled in the Cooperative Study of Sickle Cell Disease (CSSCD) before age 6 months, (2) had at least 1 study-mandated brain MRI at age 6 years or older, and (3) had no overt stroke before a first MRI. MRI results and clinical and laboratory parameters were tested as predictors of stroke. Results: Among 248 eligible patients, mean age at first MRI was 8.3 ± 1.9 years, and mean follow-up after baseline MRI was 5.2 ± 2.2 years. Five (8.1{\%}) of 62 patients with silent infarct had strokes compared with 1 (0.5{\%}) of 186 patients without prior silent infarct; incidence per 100 patient-years of follow-up was increased 14-fold (1.45 per 100 patient-years vs 0.11 per 100 patient-years, P = .006). Of several clinical and laboratory parameters examined, silent infarct was the strongest independent predictor of stroke (hazard ratio = 7.2, P = .027). Conclusions: Silent infarct identified at age 6 years or older is associated with increased stroke risk.",
author = "Miller, {Scott T.} and Macklin, {Eric A.} and Pegelow, {Charles H.} and Kinney, {Thomas R.} and Sleeper, {Lynn A.} and Bello, {Jacqueline A.} and DeWitt, {L. Dana} and Gallagher, {Dianne M.} and Ludovico Guarini and Moser, {Franklin G.} and Kwaku Ohene-Frempong and Nelson Sanchez and Vichinsky, {Elliott P.} and Wang, {Winfred C.} and Wethers, {Doris L.} and Younkin, {Donald P.} and Zimmerman, {Robert A.} and DeBaun, {Michael R.}",
year = "2001",
doi = "10.1067/mpd.2001.117580",
language = "English (US)",
volume = "139",
pages = "385--390",
journal = "Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - Silent infarction as a risk factor for overt stroke in children with sickle cell anemia

T2 - A report from the Cooperative Study of Sickle Cell Disease

AU - Miller, Scott T.

AU - Macklin, Eric A.

AU - Pegelow, Charles H.

AU - Kinney, Thomas R.

AU - Sleeper, Lynn A.

AU - Bello, Jacqueline A.

AU - DeWitt, L. Dana

AU - Gallagher, Dianne M.

AU - Guarini, Ludovico

AU - Moser, Franklin G.

AU - Ohene-Frempong, Kwaku

AU - Sanchez, Nelson

AU - Vichinsky, Elliott P.

AU - Wang, Winfred C.

AU - Wethers, Doris L.

AU - Younkin, Donald P.

AU - Zimmerman, Robert A.

AU - DeBaun, Michael R.

PY - 2001

Y1 - 2001

N2 - Objective: To determine whether children with homozygous sickle cell anemia (SCD) who have silent infarcts on magnetic resonance imaging (MRI) of the brain are at increased risk for overt stroke. Methods: We selected patients with homozygous SCD who (1) enrolled in the Cooperative Study of Sickle Cell Disease (CSSCD) before age 6 months, (2) had at least 1 study-mandated brain MRI at age 6 years or older, and (3) had no overt stroke before a first MRI. MRI results and clinical and laboratory parameters were tested as predictors of stroke. Results: Among 248 eligible patients, mean age at first MRI was 8.3 ± 1.9 years, and mean follow-up after baseline MRI was 5.2 ± 2.2 years. Five (8.1%) of 62 patients with silent infarct had strokes compared with 1 (0.5%) of 186 patients without prior silent infarct; incidence per 100 patient-years of follow-up was increased 14-fold (1.45 per 100 patient-years vs 0.11 per 100 patient-years, P = .006). Of several clinical and laboratory parameters examined, silent infarct was the strongest independent predictor of stroke (hazard ratio = 7.2, P = .027). Conclusions: Silent infarct identified at age 6 years or older is associated with increased stroke risk.

AB - Objective: To determine whether children with homozygous sickle cell anemia (SCD) who have silent infarcts on magnetic resonance imaging (MRI) of the brain are at increased risk for overt stroke. Methods: We selected patients with homozygous SCD who (1) enrolled in the Cooperative Study of Sickle Cell Disease (CSSCD) before age 6 months, (2) had at least 1 study-mandated brain MRI at age 6 years or older, and (3) had no overt stroke before a first MRI. MRI results and clinical and laboratory parameters were tested as predictors of stroke. Results: Among 248 eligible patients, mean age at first MRI was 8.3 ± 1.9 years, and mean follow-up after baseline MRI was 5.2 ± 2.2 years. Five (8.1%) of 62 patients with silent infarct had strokes compared with 1 (0.5%) of 186 patients without prior silent infarct; incidence per 100 patient-years of follow-up was increased 14-fold (1.45 per 100 patient-years vs 0.11 per 100 patient-years, P = .006). Of several clinical and laboratory parameters examined, silent infarct was the strongest independent predictor of stroke (hazard ratio = 7.2, P = .027). Conclusions: Silent infarct identified at age 6 years or older is associated with increased stroke risk.

UR - http://www.scopus.com/inward/record.url?scp=0034834753&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034834753&partnerID=8YFLogxK

U2 - 10.1067/mpd.2001.117580

DO - 10.1067/mpd.2001.117580

M3 - Article

C2 - 11562618

AN - SCOPUS:0034834753

VL - 139

SP - 385

EP - 390

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

IS - 3

ER -