Journal article
Intracerebral Hemorrhage in Multiple Sclerosis: A Retrospective Cohort Study
Journal of stroke and cerebrovascular diseases, Vol.28(2), pp.267-275
02/2019
DOI: 10.1016/j.jstrokecerebrovasdis.2018.09.050
PMID: 30385221
Abstract
Background: To identify the vascular risk factors associated with the occurrence of intracerebral hemorrhage (ICH) in Multiple Sclerosis (MS) patients.
This is an observational, retrospective cohort study using the nationwide electronic medical records (EMR) database. Patients with the diagnosis of MS were extracted from inpatient and outpatient EMR using the international classification of diseases, ninth/tenth revisions, clinical modification codes. We excluded patients younger than 18 years, and those where gender was not specified. Patients were further stratified based on their demographics, risk factors, medications, and comorbidities. Tobacco, diabetes, hypertension, and alcohol were the predicting variables; antiplatelet medication, and anticoagulant agents were the primary exposures for the development of ICH. A validated diagnosis code algorithm defined the diagnosis of ICH. Multivariable logistic regression models were utilized to assess the risk of ICH in MS patients.
Of the total 57,099 MS patients (women: 75%, n = 41,517), 107 (.19%) sustained an ICH. Age (OR = 2.74, CI = 1.13-6.62), use of anticoagulants (OR = 2.15, 95% CI = 1.30-3.56, P = .0028), and history of tobacco exposure (OR = 2.44, CI = 1.37-4.36, P = .0025) were associated with increased risk of ICH. Use of antiplatelet and disease-modifying drugs (DMDs) showed a protective trend against ICH.
Tobacco exposure and anticoagulant use were strongly associated with increased risk of ICH in patients with MS. There might be a protective effect that antiplatelet and DMDs have in the pathophysiology of this disease. Further prospective investigations are warranted to establish these associations.
Details
- Title: Subtitle
- Intracerebral Hemorrhage in Multiple Sclerosis: A Retrospective Cohort Study
- Creators
- Maryam Zulfiqar - Department of Neurology, University of New Mexico, Albuquerque, New MexicoFares Qeadan - Clinical and Translational Science Center, University of New Mexico, Albuquerque, New MexicoAsad Ikram - Department of Neurology, University of New Mexico, Albuquerque, New MexicoMudassir Farooqui - University of Iowa, NeurologySarah P Richardson - Department of Neurology, University of New Mexico, Albuquerque, New MexicoChristopher S Calder - Department of Neurology, University of New Mexico, Albuquerque, New MexicoSyed A Quadri - Department of Neurosurgery, California Institute of Neurosciences, Thousand Oaks, CaliforniaPuja Mathur - Department of Neurology, University of New Mexico, Albuquerque, New MexicoCorey Ford - Department of Neurology, University of New Mexico, Albuquerque, New MexicoSantiago O.Gutierrez - Department of Neurology, University of Iowa Hospitals and Clinic, Iowa City, IowaEnrique Liera - Department of Neurology, University of Iowa Hospitals and Clinic, Iowa City, IowaHarry Snow - Clinical and Translational Science Center, University of New Mexico, Albuquerque, New MexicoJoel N.Gonzalez - Department of Neurology, University of New Mexico, Albuquerque, New MexicoAtif Zafar - Department of Neurology, University of New Mexico, Albuquerque, New Mexico
- Resource Type
- Journal article
- Publication Details
- Journal of stroke and cerebrovascular diseases, Vol.28(2), pp.267-275
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jstrokecerebrovasdis.2018.09.050
- PMID
- 30385221
- ISSN
- 1052-3057
- eISSN
- 1532-8511
- Grant note
- 8UL1TR000041 / National Institutes of Health UL1TR001449 / CTSC NIH
- Language
- English
- Date published
- 02/2019
- Academic Unit
- Neurology; Radiology; Epidemiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984088186502771
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