{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T15:13:32Z","timestamp":1784042012079,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R00HL172303"],"award-info":[{"award-number":["R00HL172303"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001422","name":"American Society of Hematology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001422","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Immune\u2010mediated thrombotic thrombocytopenic purpura (iTTP) survivors are predisposed to silent cerebral infarctions (SCI) defined as radiological evidence of brain ischaemia without focal symptoms. This study examined risk factors associated with SCI burden in iTTP survivors during remission. We included the first 39 iTTP survivors enrolled in the prospective neurological sequelae of TTP (NeST) study. Participants underwent brain magnetic resonance imaging during clinical remission. SCI burden was quantified using the modified age\u2010related white matter changes (ARWMC) score. Multivariate linear regression models identified the predictors of SCI burden. Of 39 participants, 20 (51.3%) had SCI. On univariate analysis, higher SCI burden was associated with older age, elevated level of peak serum creatinine and peak lactate dehydrogenase (LDH) during the index iTTP episode, comorbidities including diabetes mellitus, prior stroke, coronary artery disease (CAD) and family history of cerebrovascular disease. In the multivariate model, higher SCI burden was significantly associated with older age (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), diabetes mellitus (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.007), prior stroke (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.01), CAD (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.02) and elevated peak LDH (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.046). Total days of thrombocytopenia (surrogate for \u2018days with active iTTP\u2019) were not associated with SCI burden. Both modifiable and non\u2010modifiable factors contribute to SCI in iTTP survivors. Targeted management of cardiovascular comorbidities during remission may reduce long\u2010term neurological sequelae. Validation in larger cohorts is needed.\n                  <\/jats:p>","DOI":"10.1111\/bjh.70256","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T03:26:39Z","timestamp":1765250799000},"page":"654-660","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Risk factors for silent cerebral infarction in immune\u2010mediated thrombotic thrombocytopenic survivors"],"prefix":"10.1111","volume":"208","author":[{"given":"Binish","family":"Javed","sequence":"first","affiliation":[{"name":"Division of Hematology, Department of Medicine Johns Hopkins University School of Medicine  Baltimore Maryland USA"},{"name":"Atal Bihari Vajpayee Institute of Medical Science &amp; Dr. Ram Manohar Lohia Hospital  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Yu","sequence":"additional","affiliation":[{"name":"School of Medicine University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenna","family":"Brown","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Meade","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria F.","family":"Gerber","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael B.","family":"Streiff","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peggy","family":"Kraus","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Merrill","sequence":"additional","affiliation":[{"name":"Divison of Hematology and Oncology, Department of Medicine West Virginia University  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9997-454X","authenticated-orcid":false,"given":"Allyson M.","family":"Pishko","sequence":"additional","affiliation":[{"name":"Divison of Hematology and Oncology University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Yui","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakhi P.","family":"Naik","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5741-1255","authenticated-orcid":false,"given":"Robert A.","family":"Brodsky","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doris D.","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology, Department of Radiology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shruti","family":"Chaturvedi","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-04-636431"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199811263392202"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rpth.2024.102388"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2025.103168"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/rth2.12802"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-02-272682"},{"key":"e_1_2_12_8_1","first-page":"239","article-title":"Risk of \u201csilent stroke\u201d in patients older than 60\u2009years: risk assessment and clinical perspectives","volume":"5","author":"Lim JS","year":"2010","journal-title":"Clin Interv Aging"},{"issue":"4","key":"e_1_2_12_9_1","first-page":"325","article-title":"Silent cerebral infarction during immune TTP remission: prevalence, predictors, and impact on cognition","volume":"142","author":"Chaturvedi S","year":"2023","journal-title":"Blood"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.63.2.246"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022066"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1137019"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1722610"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.19293"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020009150"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2015.08.025"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.867329"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13179"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.32.6.1318"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.10045"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.14060"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2009.02101.x"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.20169"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.28.6.1158"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.516575"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21881"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2019001056"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-014-0119-0"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-06-2373"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2010.06.006"}],"container-title":["British Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bjh.70256","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/bjh.70256","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bjh.70256","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T18:26:54Z","timestamp":1772994414000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/bjh.70256"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,8]]},"references-count":29,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1111\/bjh.70256"],"URL":"https:\/\/doi.org\/10.1111\/bjh.70256","archive":["Portico"],"relation":{},"ISSN":["0007-1048","1365-2141"],"issn-type":[{"value":"0007-1048","type":"print"},{"value":"1365-2141","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,8]]},"assertion":[{"value":"2025-08-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}