{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T19:28:16Z","timestamp":1789500496184,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,2,15]],"date-time":"2019-02-15T00:00:00Z","timestamp":1550188800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Korea Otsuka Pharmaceutical Company"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>White matter hyperintensities (<jats:styled-content style=\"fixed-case\">WMH<\/jats:styled-content>) are a predictor of stroke among elderly individuals. This study aimed to evaluate the association between <jats:styled-content style=\"fixed-case\">WMH<\/jats:styled-content> severity and the risk of recurrent vascular events among Asian patients with ischaemic stroke with small\u2010vessel disease (<jats:styled-content style=\"fixed-case\">SVD<\/jats:styled-content>) including micro\/macrobleeds and lacunes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from participants (<jats:italic>n<\/jats:italic>\u00a0=\u00a01454) in the PICASSO (PreventIon of <jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content>rdiovascular Events in <jats:styled-content style=\"fixed-case\">iS<\/jats:styled-content>chemic Stroke Patients with High Risk of Cerebral HemOrrhage) trial were reviewed. The severity of <jats:styled-content style=\"fixed-case\">WMH<\/jats:styled-content> in baseline brain magnetic resonance imaging scans was assessed using the Fazekas scale. The association between <jats:styled-content style=\"fixed-case\">WMH<\/jats:styled-content> severity and stroke (ischaemic or hemorrhagic) and major vascular events (<jats:styled-content style=\"fixed-case\">MVE<\/jats:styled-content>s) (a composite of stroke\/myocardial infarction\/vascular death) was assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Study patients had a significant burden of SVD: Fazekas score 0 (<jats:italic>n<\/jats:italic>\u00a0=\u00a02), 1 (<jats:italic>n<\/jats:italic>\u00a0=\u00a0426), 2 (<jats:italic>n<\/jats:italic>\u00a0=\u00a0650) and 3 (<jats:italic>n<\/jats:italic>\u00a0=\u00a0376) [median Fazekas score 2 (mean follow\u2010up, 1.9 \u00b1 1.3 years)]. The stroke incidence rate per 100 personyears was 2.6 in the Fazekas 0\u20131 group, 3.6 in the Fazekas 2 group and 7.0 in the Fazekas 3 group, and the rates for MVEs were 3.3, 4.3 and 7.6, respectively. Compared with the Fazekas 0\u20131 group, the Fazekas 3 group was associated with a higher risk of stroke [adjusted hazard ratio (HR), 2.15; 95% confidence interval (CI), 1.19\u20133.88; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.011], ischaemic stroke (adjusted HR, 2.11; 95% CI, 1.07\u20134.15; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.031), hemorrhagic stroke (adjusted HR, 3.72; 95% CI, 1.09\u201312.70; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.036) and MVEs (adjusted HR, 2.09; 95% CI, 1.20\u20133.66; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.010).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Advanced <jats:styled-content style=\"fixed-case\">WMH<\/jats:styled-content> in Asian patients with ischaemic stroke with <jats:styled-content style=\"fixed-case\">SVD<\/jats:styled-content> burden was associated with an increased risk of recurrent vascular events. It may exert an effect as a prognostic indicator in high risk of recurrent vascular events.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.13908","type":"journal-article","created":{"date-parts":[[2019,1,14]],"date-time":"2019-01-14T05:10:05Z","timestamp":1547442605000},"page":"911-918","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["White matter hyperintensities and recurrent stroke risk in patients with stroke with small\u2010vessel disease"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2681-1878","authenticated-orcid":false,"given":"J.\u2010H.","family":"Park","sequence":"first","affiliation":[{"name":"Department of Neurology Myongji Hospital Hanyang University College of Medicine Goyang"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. H.","family":"Heo","sequence":"additional","affiliation":[{"name":"Department of Neurology Kyung Hee University Hospital Seoul"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. H.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology Myongji St Mary's Hospital Seoul"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2005-0983","authenticated-orcid":false,"given":"H. S.","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Neurology Hanyang University College of Medicine Seoul"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. U.","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Neurology Asan Medical Center University of Ulsan College of Medicine Seoul"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. S.","family":"Lee","sequence":"additional","affiliation":[{"name":"Clinical Research Center Asan Medical Center Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the PICASSO investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70124-8"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c3666"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.596056"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2003.032771"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.003004"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000080939.39414.83"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.5853\/jos.2015.17.1.7"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30128-5"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000081050"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60371-8"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182a43e33"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.22.2961"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.535427"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.61.10.1531"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.140147"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awt184"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.498535"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pscychresns.2006.09.003"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1159\/000113863"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fene.13908","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.13908","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ene.13908","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.13908","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T22:27:45Z","timestamp":1693348065000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.13908"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,15]]},"references-count":20,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1111\/ene.13908"],"URL":"https:\/\/doi.org\/10.1111\/ene.13908","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,15]]},"assertion":[{"value":"2018-09-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}