{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T08:25:45Z","timestamp":1781166345176,"version":"3.54.1"},"reference-count":0,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T00:00:00Z","timestamp":1739232000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T00:00:00Z","timestamp":1739232000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cerebrovasc Dis"],"abstract":"<jats:p>Introduction: Approximately 20% of strokes in the United States are preceded by either a stroke or transient ischemic attack (TIA). Determining which stroke patients are at higher risk for recurrence allows for individualized, aggressive secondary stroke prevention. A comprehensive clinical decision tool, considering the full spectrum of radiological brain health\" including small vessel disease parameters, is currently lacking.  Furthermore, large-scale characterization of pre-existing radiological brain health may elucidate novel phenotypes. This study aims (1) to characterize imaging manifestations of brain health at a population level, and associated demographic and clinical risk factors at the time of index stroke and (2) to create a 90-day and three-year prediction models of cerebrovascular disease recurrence (ischemic or hemorrhagic stroke) incorporating comprehensive parameters from routine clinical imaging.  \n\nMethods: Our overall cohort was estimated to consist of 4250 patients hospitalized with stroke, including 525 with hemorrhagic and 3725 with ischemic\/TIA subtypes, ascertained in the Greater Cincinnati\/Northern Kentucky Stroke Study (GCNKSS) population of 1.4 million residents from January 1, 2015 through December 31, 2015.  Among 3725 ischemic stroke\/TIA patients, based on published and ongoing data collection, we estimated that approximately 16% will have a recurrent ischemic or hemorrhagic stroke over the subsequent three years. Among these, 80% were estimated to have MR imaging for review. Leveraging extensive clinical and demographic data already collected in the 2015 NIH-funded GCKNSS study, we will have obtained and centrally characterized magnetic resonance imaging (MRI), acute CT, and vascular data in patients with hospitalized stroke\/TIAs.  We will determine if and how pre-existing imaging parameters cluster using factor analysis, and identify associated demographic and clinical risk factors in multivariable modeling.  We will develop short term (90-day) and long term (three-year) risk prediction models using the machine learning approach of random survival forest with internal validation, and perform Cox regression models as a sensitivity analysis.\n\nConclusion: The primary outcome is recurrence defined as any stroke (ischemic or hemorrhagic) occurring after index ischemic stroke or TIA event.  For index ischemic strokes, the second event must within a different vascular territory if &lt;14 days from the index event.\n<\/jats:p>","DOI":"10.1159\/000543431","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T17:00:59Z","timestamp":1739293259000},"page":"1-15","source":"Crossref","is-referenced-by-count":3,"title":["Assessing Population-Based Radiological Brain Health in Stroke Epidemiology (APRISE): Rationale and Design"],"prefix":"10.1159","author":[{"given":"Pooja","family":"Khatri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Sucharew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell P.","family":"Sawyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek","family":"Khandwala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lily Li-li","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Cornelius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Gaskill-Shipley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas A.","family":"Tomsick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shantala","family":"Gangatirkar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brady Jamal","family":"Williamson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Maloney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Horn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice","family":"Carrozzella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Alwell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Haverbusch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett M.","family":"Kissela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achala","family":"Vagal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2025,2,11]]},"container-title":["Cerebrovascular Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/ced\/article-pdf\/doi\/10.1159\/000543431\/4335846\/000543431.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/ced\/article-pdf\/doi\/10.1159\/000543431\/4335846\/000543431.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:08:57Z","timestamp":1745420937000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000543431"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,11]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1159\/000543431","archive":["Portico"],"relation":{},"ISSN":["1015-9770","1421-9786"],"issn-type":[{"value":"1015-9770","type":"print"},{"value":"1421-9786","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,11]]}}}