This Article Full Text Full Text (PDF) All Versions of this Article: 40/7/2327    most recent STROKEAHA.109.548222v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Google Scholar Articles by Buyck, J.-F. Articles by Tzourio, C. PubMed PubMed Citation Articles by Buyck, J.-F. Articles by Tzourio, C. Pubmed/NCBI databases Medline Plus Health Information Brain Diseases Stroke Related Collections CT and MRI Risk Factors for Stroke Epidemiology

(Stroke. 2009;40:2327.)
© 2009 American Heart Association, Inc.

Original Contributions

Cerebral White Matter Lesions Are Associated With the Risk of Stroke But Not With Other Vascular Events

The 3-City Dijon Study

Jean-François Buyck, MSc; Carole Dufouil, PhD; Bernard Mazoyer, MD, PhD; Pauline Maillard, PhD; Pierre Ducimetière, PhD; Annick Alpérovitch, MD, MSc; Marie-Germaine Bousser, MD; Tobias Kurth, MD, ScD Christophe Tzourio, MD, PhD

From INSERM U708 (J.-F.B., C.D., A.A., T.K., C.T.), Paris, France; UPMC Univ Paris06 (J.-F.B., C.D., A.A., T.K., C.T.), Paris, France; Centre d’Imagerie-Neurosciences et Applications aux Pathologies (B.M., P.M.), CI-NAPS, CNRS, CEA, Université de Caen, Université Paris Descartes, GIP Cyceron, France; INSERM U780 (P.D.), Villejuif, France; the Department of Neurology (M.-G.B., C.T.), Hôpital Lariboisière, Paris, France; and the Division of Preventive Medicine (T.K.), Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass.

Correspondence to Christophe Tzourio, MD, PhD, INSERM Unit 708, Hopital La Salpêtrière, 75651 Paris Cedex 13 France. E-mail christophe.tzourio{at}upmc.fr

Background and Purpose— 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.

Methods— The 3-City Study is a population-based prospective cohort of people aged 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.

Results— 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.

Conclusions— 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.

Key Words: MRI • myocardial infarction • stroke • vascular death • white matter