Abstract 101: Incidental Subclinical Intraparenchymal Hemorrhages And Risk Of Subsequent

Background: Subclinical intraparenchymal hemorrhages (IPH) are infrequently detected on brain magnetic resonance imaging (MRI), although the prognostic significance of such findings remains unknown. Methods: We analyzed data from the cohort of 5,888 study participants aged 65 years and older recruited in the Cardiovascular Health Study (CHS) from four U.S. communities. Each participant underwent assessment of medical history, cardiovascular risk factors, and brain MRI at baseline. We identified participants who had asymptomatic IPH on MRI and selected 3 age- and gender-matched controls without IPH. We compared the rates of cardiovascular events using logistic regression analysis including incident myocardial infarction, stroke and death between those with and without asymptomatic IPHs. Results: A total of 23 participants had asymptomatic IPHs classified as acute (n=3), subacute (n=4), and chronic (n=16). There were no differences in the proportion of participants with chronic hypertension (65.2% versus 71.0%) and previous stroke (8.7% versus 7.2%) between those with (n=23) and without asymptomatic IPHs (n=69). The proportion of participants with concurrent small (17.4% versus 11.6%) and large lacunar infarctions on MRI (43.5% versus 39.1%) was similar. Over a 14 year follow-up period, the risk of incident stroke (relative risk [RR] 0.6, 95% confidence interval [CI] 0.2-2.0), myocardial infarction (RR 0.3, 95% CI 0.06-1.4) and death (RR 0.6, 95% CI 0.2-1.7) was not different between participants with IPH compared with controls. There was no difference between the two groups in regards to time to ischemic stroke or time to death by Kaplan Meier analysis. Conclusions: The risks of stroke, myocardial infarction, and death are similar between persons with asymptomatic IPHs detected on MRI compared with age- and gender-matched controls.