Journal
JOURNAL OF PERSONALIZED MEDICINE
Volume 12, Issue 9, Pages -Publisher
MDPI
DOI: 10.3390/jpm12091410
Keywords
intracranial aneurysm; subarachnoid hemorrhage; risk factors; location; smoking; hypertension
Funding
- European Commission [FP6-IST-2004-027703]
- Swiss SystemsX.ch initiative
- European Research Council under the European Union's Horizon 2020 research and innovation programme (PRYSM) [852173]
- Netherlands Cardiovascular Research Initiative
- Dutch Heart Foundation [CVON2015-08 ERASE]
- NIH
- French Regional Council of Pays-de-la-Loire (VaCaRMe program)
- Agence Nationale de la Recherche [ANR-15-CE17-0008-01]
- French Ministry of Health [NCT02848495]
- Genavie Foundation
- Societe Francaise de Radiologie
- Societe Francaise de Neuroradiologie
- Spain's Ministry of Health (Instituto de Salud Carlos III Fondo de Investigaciones sanitarias) [P19/00011]
- Spain's Ministry of Health [RICORS-ICTUS RD21/0006/0021]
- Canadian Institutes of Health Research
- Helsinki University Central Hospital EVO grant [TYH2018316]
- Stroke Association
- Agence Nationale de la Recherche (ANR) [ANR-15-CE17-0008] Funding Source: Agence Nationale de la Recherche (ANR)
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This study found that the location of intracranial aneurysms (IAs), awareness of risk factors, age, and gender are associated with the likelihood of an IA being diagnosed incidentally or ruptured. Evaluating the associations between patient and IA characteristics can help refine disease models and develop risk instruments for clinicians to make personalized decisions.
Intracranial aneurysms (IAs) are usually asymptomatic with a low risk of rupture, but consequences of aneurysmal subarachnoid hemorrhage (aSAH) are severe. Identifying IAs at risk of rupture has important clinical and socio-economic consequences. The goal of this study was to assess the effect of patient and IA characteristics on the likelihood of IA being diagnosed incidentally versus ruptured. Patients were recruited at 21 international centers. Seven phenotypic patient characteristics and three IA characteristics were recorded. The analyzed cohort included 7992 patients. Multivariate analysis demonstrated that: (1) IA location is the strongest factor associated with IA rupture status at diagnosis; (2) Risk factor awareness (hypertension, smoking) increases the likelihood of being diagnosed with unruptured IA; (3) Patients with ruptured IAs in high-risk locations tend to be older, and their IAs are smaller; (4) Smokers with ruptured IAs tend to be younger, and their IAs are larger; (5) Female patients with ruptured IAs tend to be older, and their IAs are smaller; (6) IA size and age at rupture correlate. The assessment of associations regarding patient and IA characteristics with IA rupture allows us to refine IA disease models and provide data to develop risk instruments for clinicians to support personalized decision-making.
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