The cardiovascular outcome of patients with motor impairment and extensive leukoaraiosis

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D Inzitari1, A Di Carlo, M Mascalchi

  • 1Department of Neurological and Psychiatric Sciences, University of Florence, Italy.

Archives of Neurology
|July 1, 1995
PubMed

Insights

Patients with motor impairment and extensive leukoaraiosis face a significantly higher risk of stroke and cardiovascular events. Lacunar infarction appears to be a key factor influencing their poor long-term outcome.

Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Radiology

Background:

  • The long-term prognosis for patients exhibiting motor impairment and extensive leukoaraiosis on computed tomographic scans remains largely unknown.
  • Leukoaraiosis, a white matter change, is often associated with cerebrovascular disease.

Purpose of the Study:

  • To investigate the incidence of stroke, myocardial infarction, and death in patients with motor impairment and extensive leukoaraiosis.
  • To compare the cardiovascular outcomes of these patients against a control group without leukoaraiosis.

Main Methods:

  • A cohort study involving 31 patients with motor impairment and extensive leukoaraiosis (cases) and 68 neurologic patients without leukoaraiosis (controls).
  • Both groups underwent routine neurologic and cardiovascular assessments.
  • Follow-up duration averaged approximately 50 months for both cases and controls.

Main Results:

  • The 6-year cumulative risk of stroke was significantly higher in cases (49%) compared to controls (16%), with a hazard ratio of 3.0.
  • The combined risk of stroke or myocardial infarction was also substantially greater in cases (69%) versus controls (36%), hazard ratio 2.9.
  • Adjusting for conventional vascular risk factors did not eliminate the increased stroke risk in cases, but adjustment for lacunar stroke history and imaging reduced the observed risk.

Conclusions:

  • Patients presenting with motor impairment and extensive leukoaraiosis experience a markedly poor cardiovascular outcome.
  • The presence of lacunar infarction may be a primary determinant of the adverse long-term prognosis in this patient population.
Abstract

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