Buyck Jean-François, Dufouil Carole, Mazoyer Bernard, Maillard Pauline, Ducimetière Pierre, Alpérovitch Annick, Bousser Marie-Germaine, Kurth Tobias, Tzourio Christophe
INSERM Unit 708, Paris, France.
Stroke. 2009 Jul;40(7):2327-31. doi: 10.1161/STROKEAHA.109.548222. Epub 2009 May 14.
White matter lesions (WMLs) have been shown to be associated with the risk of stroke in previous studies but little is known about the prediction of other vascular events. We evaluated the risk of stroke and other vascular events according to WML volume in a large population-based sample. We also studied WML volume by type (deep or periventricular) in relation to these events.
The 3-City Study is a population-based prospective cohort of people aged >or=65 years followed up for, on average, 4.9 years. Among them, 1643 participants free of prevalent vascular events had quantitative measurements of WML volume at baseline using a fully automatic method. The risks of incident major vascular events according to WML volume were evaluated using Cox proportional hazards models.
The risk of incident stroke significantly increased with increasing baseline WML volume and was multiplied by 5 for those in the highest quartile of WML volume. Nonstroke vascular events' incidence was not associated with WML volumes, whatever their type.
WMLs are an independent predictor of stroke in the elderly. This association is specific because WMLs are not associated with the risk of other vascular events.
既往研究表明白质病变（WMLs）与中风风险相关，但对于其他血管事件的预测了解甚少。我们在一个基于人群的大样本中，根据WML体积评估中风及其他血管事件的风险。我们还按类型（深部或脑室周围）研究了WML体积与这些事件的关系。
三城市研究是一项针对年龄≥65岁人群的基于人群的前瞻性队列研究，平均随访4.9年。其中，1643名无既往血管事件的参与者在基线时使用全自动方法对WML体积进行了定量测量。根据WML体积，使用Cox比例风险模型评估发生主要血管事件的风险。
随着基线WML体积增加，发生中风的风险显著增加，WML体积处于最高四分位数的人群中风风险增加至5倍。无论WML类型如何，非中风血管事件的发生率均与WML体积无关。
WMLs是老年人中风的独立预测因素。这种关联具有特异性，因为WMLs与其他血管事件的风险无关。
