{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T13:40:36Z","timestamp":1791726036907,"version":"4.3.4"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2012,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Purpose\u2014<\/jats:title>\n                    <jats:p>Impairments in cerebrovascular reserve (CVR) have been variably associated with increased risk of ischemic events and may stratify stroke risk in patients with high-grade internal carotid artery stenosis or occlusion. The purpose of this study is to perform a systematic review and meta-analysis to summarize the association of CVR impairment and stroke risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods\u2014<\/jats:title>\n                    <jats:p>We performed a literature search evaluating the association of impairments in CVR with future stroke or transient ischemic attack in patients with high-grade internal carotid artery stenosis or occlusion. We included studies with a minimum of 1-year patient follow-up with baseline CVR measures performed by any modality and primary outcome measures of stroke and\/or transient ischemic attack. A meta-analysis with assessment of study heterogeneity and publication bias was performed. Results were presented in a forest plot and summarized using a random-effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results\u2014<\/jats:title>\n                    <jats:p>Thirteen studies met the inclusion criteria, representing a total of 1061 independent CVR tests in 991 unique patients with a mean follow-up of 32.7 months. We found a significant positive relationship between impairment of CVR and development of stroke with a pooled random effects OR of 3.86 (95% CI, 1.99\u20137.48). Subset analysis showed that this association between CVR impairment and future risk of stroke\/transient ischemic attack remained significant regardless of ischemic outcome measure, symptomatic or asymptomatic disease, stenosis or occlusion, or CVR testing method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>CVR impairment is strongly associated with increased risk of ischemic events in carotid stenosis or occlusion and may be useful for stroke risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.112.663716","type":"journal-article","created":{"date-parts":[[2012,10,22]],"date-time":"2012-10-22T16:59:33Z","timestamp":1350925173000},"page":"2884-2891","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":305,"title":["Cerebrovascular Reserve and Stroke Risk in Patients With Carotid Stenosis or Occlusion"],"prefix":"10.1161","volume":"43","author":[{"given":"Ajay","family":"Gupta","sequence":"first","affiliation":[{"name":"From the Departments of Radiology (A.G., J.L.C., M.H., N.A., P.C.S.) and Neurology (A.Z.S., H.K., D.L.), Weill Cornell Medical College, New York\u2013Presbyterian Hospital, New York, NY; Samuel J. Wood Library &amp; C.V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, NY (D.D.); and the Department of Public Health, Weill Cornell Medical College, New York, NY (H.S., M.M., P.C.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Levi","family":"Chazen","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (A.G., J.L.C., M.H., N.A., P.C.S.) and Neurology (A.Z.S., H.K., D.L.), Weill Cornell Medical College, New York\u2013Presbyterian Hospital, New York, NY; Samuel J. Wood Library &amp; C.V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, NY (D.D.); and the Department of Public Health, Weill Cornell Medical College, New York, NY (H.S., M.M., P.C.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Hartman","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (A.G., J.L.C., M.H., N.A., P.C.S.) and Neurology (A.Z.S., H.K., D.L.), Weill Cornell Medical College, New York\u2013Presbyterian Hospital, New York, NY; Samuel J. Wood Library &amp; C.V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, NY (D.D.); and the Department of Public Health, Weill Cornell Medical College, New York, NY (H.S., M.M., P.C.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Delgado","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (A.G., J.L.C., M.H., N.A., P.C.S.) and Neurology (A.Z.S., H.K., D.L.), Weill Cornell Medical College, New York\u2013Presbyterian Hospital, New York, NY; Samuel J. Wood Library &amp; C.V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, NY (D.D.); and the Department of Public Health, Weill Cornell Medical College, New York, NY (H.S., M.M., P.C.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikesh","family":"Anumula","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (A.G., J.L.C., M.H., N.A., P.C.S.) and Neurology (A.Z.S., H.K., D.L.), Weill Cornell Medical College, New York\u2013Presbyterian Hospital, New York, NY; Samuel J. Wood Library &amp; C.V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, NY (D.D.); and the Department of Public Health, Weill Cornell Medical College, New York, NY (H.S., M.M., P.C.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huibo","family":"Shao","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (A.G., J.L.C., M.H., N.A., P.C.S.) and Neurology (A.Z.S., H.K., D.L.), Weill Cornell Medical College, New York\u2013Presbyterian Hospital, New York, NY; Samuel J. Wood Library &amp; C.V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, NY (D.D.); and the Department of Public Health, Weill Cornell Medical College, New York, NY (H.S., M.M., P.C.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhu","family":"Mazumdar","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (A.G., J.L.C., M.H., N.A., P.C.S.) and Neurology (A.Z.S., H.K., D.L.), Weill Cornell Medical College, New York\u2013Presbyterian Hospital, New York, NY; Samuel J. Wood Library &amp; C.V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, NY (D.D.); and the Department of Public Health, Weill Cornell Medical College, New York, NY (H.S., M.M., P.C.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan Z.","family":"Segal","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (A.G., J.L.C., M.H., N.A., P.C.S.) and Neurology (A.Z.S., H.K., D.L.), Weill Cornell Medical College, New York\u2013Presbyterian Hospital, New York, NY; Samuel J. Wood Library &amp; C.V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, NY (D.D.); and the Department of Public Health, Weill Cornell Medical College, New York, NY (H.S., M.M., P.C.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hooman","family":"Kamel","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (A.G., J.L.C., M.H., N.A., P.C.S.) and Neurology (A.Z.S., H.K., D.L.), Weill Cornell Medical College, New York\u2013Presbyterian Hospital, New York, NY; Samuel J. Wood Library &amp; C.V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, NY (D.D.); and the Department of Public Health, Weill Cornell Medical College, New York, NY (H.S., M.M., P.C.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Leifer","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (A.G., J.L.C., M.H., N.A., P.C.S.) and Neurology (A.Z.S., H.K., D.L.), Weill Cornell Medical College, New York\u2013Presbyterian Hospital, New York, NY; Samuel J. Wood Library &amp; C.V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, NY (D.D.); and the Department of Public Health, Weill Cornell Medical College, New York, NY (H.S., M.M., P.C.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pina C.","family":"Sanelli","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (A.G., J.L.C., M.H., N.A., P.C.S.) and Neurology (A.Z.S., H.K., D.L.), Weill Cornell Medical College, New York\u2013Presbyterian Hospital, New York, NY; Samuel J. Wood Library &amp; C.V. 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