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.
N1 - Funding Information:
Supported in part by the National Institutes of Health, National Heart, Lung, and Blood Institute, Contract No. N01-HB-47110.
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
SN - 0022-3476
VL - 139
SP - 385
EP - 390
JO - Journal of Pediatrics
JF - Journal of Pediatrics
IS - 3
ER -