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CSVD Severity Up for Minority Intracerebral Hemorrhage Survivors

THURSDAY, April 22, 2021 -- White and minority survivors of primary intracerebral hemorrhage (ICH) have significant differences in subtypes and severity of cerebral small vessel disease (CSVD), which has implications for ICH recurrence risk, according to a study published online April 21 in Neurology.

Juan Pablo Castello, M.D., from Massachusetts General Hospital in Boston, and colleagues examined whether racial/ethnic differences in magnetic resonance imaging (MRI)-defined CSVD subtype and severity contribute to disparities in the risk for ICH recurrence. Data were analyzed from 593 participants from the Massachusetts General Hospital ICH study and 329 participants from the Ethnic/Racial Variations of Intracerebral Hemorrhage study. ICH cases were classified as cerebral amyloid angiopathy (CAA)-related, hypertensive arteriopathy (HTNA)-related, and mixed etiology using CVSD markers derived from MRIs. CSVD burden was quantified using validated global, CAA-specific, and HTNA-specific scores. CVSD subtype and severity were compared among White, Black, and Hispanic ICH survivors (655, 130, and 137 patients, respectively).

The researchers observed greater global CSVD and HTNA burden on MRI among minority ICH survivors. Furthermore, higher HTNA burden was seen in minority survivors of HTNA-related and mixed-etiology ICH, resulting in elevated ICH recurrence risk.

"Future studies of ICH survivors will benefit from incorporating MRI-based assessment of underlying CSVD, and will need to focus on other potential contributors to racial/ethnic disparities in ICH recurrence, including social determinants of health," the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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