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@ARTICLE{Rodrigues:281350,
      author       = {Rodrigues, Mark A and Seiffge, David and Samarasekera,
                      Neshika and Moullaali, Tom J and Wardlaw, Joanna M and
                      Schreiber, Stefanie and Behymer, Tyler P and Khandwala,
                      Vivek and Stanton, Robert J and Vagal, Vaibhav and Woo,
                      Daniel and Zedde, Marialuisa and Pascarella, Rosario and
                      Charidimou, Andreas and Warren, Andrew and Greenberg, Steven
                      M and Eppinger, Sebastian and Gattringer, Thomas and
                      Casolla, Barbara and Cordonnier, Charlotte and Werring,
                      David J and Al-Shahi Salman, Rustam},
      collaboration = {Edinburgh CAA criteria {prognosis collaborators}},
      othercontributors = {Al-Shahi Salman, Rustam and Loan, James J M and Moullaali,
                          Tom J and Rodrigues, Mark A and Samarasekera, Neshika and
                          Smith, Colin J and Wardlaw, Joanna M and Seiffge, David and
                          Werring, David J and Ulbrich, Philipp and Schreiber, Frank
                          and Schreiber, Stefanie and Pascarella, Rosario and Zedde,
                          Marialuisa and Charidimou, Andreas and Greenberg, Steven M
                          and Warren, Andrew and Behymer, Tyler and Khandwala, Vivek
                          and Stanton, Robert and Vagal, Vaibhav and Woo, Daniel and
                          Eppinger, Sebastian and Gattringer, Thomas and Boulouis,
                          Grégoire and Caparros, François and Casolla, Barbara and
                          Cordonnier, Charlotte and Dequatre-Ponchelle, Nelly and
                          Hénon, Hilde and Puy, Laurent and Rossi, Costanza},
      title        = {{A}ssociation between the {E}dinburgh {CT} and genetic
                      diagnostic criteria for cerebral amyloid
                      angiopathy-associated lobar intracerebral haemorrhage and
                      recurrent intracerebral haemorrhage: an individual patient
                      data meta-analysis.},
      journal      = {The lancet},
      volume       = {24},
      number       = {10},
      issn         = {1474-4422},
      address      = {London},
      publisher    = {Lancet Publ. Group},
      reportid     = {DZNE-2025-01097},
      pages        = {828 - 839},
      year         = {2025},
      abstract     = {Patients with lobar intracerebral haemorrhage and MRI
                      biomarkers of cerebral amyloid angiopathy have a greater
                      risk of recurrent intracerebral haemorrhage than patients
                      without these biomarkers. However, access to MRI is limited.
                      We aimed to determine whether the Edinburgh CT-only and
                      CT-APOE diagnostic criteria for cerebral amyloid
                      angiopathy-related lobar intracerebral haemorrhage are
                      associated with recurrent intracerebral haemorrhage.We did a
                      meta-analysis of individual patient data from cohort studies
                      identified at the 2018 International cerebral amyloid
                      angiopathy conference in Lille, France, assessing patients
                      with lobar intracerebral haemorrhage with available
                      diagnostic CT imaging that had been, or could be, rated for
                      the Edinburgh cerebral amyloid angiopathy criteria imaging
                      features, and with follow-up data for recurrent
                      intracerebral haemorrhage and death. Eligible patients were
                      aged 16 years or older with first or recurrent spontaneous
                      lobar intracerebral haemorrhage diagnosed by non-contrast
                      brain CT, with no evidence of an underlying cause other than
                      cerebral small vessel disease. Collaborators provided
                      individual patient-level data. The primary outcome was first
                      recurrent intracerebral haemorrhage occurring at least 30
                      days after the index event, analysed using primary two-stage
                      (cohort-level) and secondary one-stage (pooled)
                      meta-analyses with multivariable regression models with a
                      competing risk of death, adjusted for age, sex, and CT small
                      vessel disease score. Pooled analyses were adjusted for
                      previous intracerebral haemorrhage, dementia, hypertension,
                      and cohort clustering. All analyses were done in R Project
                      for Statistical Computing (version 4.5.0).We included eight
                      cohorts from Austria, France, Germany, Italy, the UK, and
                      the USA, with 1705 eligible patients for the CT-only
                      criteria. In the primary two-stage meta-analysis of the
                      CT-only criteria (562 patients from three European cohorts,
                      median age 76 years [IQR 68-82], 282 $[50\%]$ female and 280
                      $[50\%]$ male), 69 patients had a recurrent intracerebral
                      haemorrhage over 1381 person-years' follow-up. The
                      proportion with recurrent intracerebral haemorrhage during
                      5-year follow-up in the intermediate-risk and high-risk
                      CT-only cerebral amyloid angiopathy criteria group was 48
                      $(16\%)$ of 307 patients compared with 21 $(8\%)$ of 255
                      patients in the low-risk group (adjusted sub-distribution
                      hazard ratio [HR] 1·79, $95\%$ CI 1·05-3·05, p=0·032).
                      In the one-stage meta-analysis of the CT-only criteria (1620
                      patients with lobar intracerebral haemorrhage from eight
                      cohorts, median age 73 years [IQR 62-80], 763 $[47\%]$
                      female and 857 $[53\%]$ male), 171 patients had a recurrent
                      intracerebral haemorrhage over 3208 person-years' follow-up.
                      Cumulative 5-year incidence of recurrent intracerebral
                      haemorrhage in the low-risk CT-only cerebral amyloid
                      angiopathy criteria group was 45 $(12\%)$ of 727 patients
                      compared with 54 $(16\%)$ of 513 patients in the
                      intermediate-risk group (adjusted sub-distribution HR 1·68,
                      $95\%$ CI 1·21-2·32; p=0·0018), and 72 $(26\%)$ of 380
                      patients in the high-risk group (adjusted sub-distribution
                      HR 2·97, 1·50-5·89, p=0·0018). We included six cohorts
                      with 1021 eligible patients for the CT-APOE criteria; 15
                      patients with missing baseline data were excluded. There
                      were insufficient outcomes in individual CT-APOE cohorts to
                      do the two-stage meta-analysis. In the one-stage
                      meta-analysis of the CT-APOE criteria (1006 patients, median
                      age 71 years [IQR 58-79, 477 $[47\%]$ female and 529
                      $[53\%]$ male), 74 patients had a recurrent intracerebral
                      haemorrhage over 1495 person-years' follow-up. Cumulative
                      3-year incidence of recurrent intracerebral haemorrhage was
                      34 $(15\%)$ of 320 patients in the high-risk CT-APOE
                      cerebral amyloid angiopathy criteria group versus 14 $(8\%)$
                      of 322 patients in the low-risk group (adjusted
                      sub-distribution HR 2·22 $[95\%$ CI 1·36-3·61],
                      p=0·0014).The Edinburgh CT-only and CT-APOE diagnostic
                      criteria for cerebral amyloid angiopathy-associated lobar
                      intracerebral haemorrhage were associated with a greater
                      incidence of recurrent intracerebral haemorrhage. These
                      findings could aid personalised prediction and targeted
                      secondary prevention in standard clinical practice where
                      brain CT is available.UK Medical Research Council, The
                      Stroke Association, The Wellcome Trust, and The British
                      Heart Foundation.},
      keywords     = {Humans / Cerebral Amyloid Angiopathy: genetics / Cerebral
                      Amyloid Angiopathy: diagnostic imaging / Cerebral Amyloid
                      Angiopathy: complications / Cerebral Amyloid Angiopathy:
                      diagnosis / Cerebral Hemorrhage: diagnostic imaging /
                      Cerebral Hemorrhage: genetics / Cerebral Hemorrhage:
                      etiology / Recurrence / Male / Female / Tomography, X-Ray
                      Computed / Aged / Middle Aged / Cohort Studies / Aged, 80
                      and over / Apolipoproteins E: genetics / Apolipoproteins E
                      (NLM Chemicals)},
      cin          = {AG Schreiber},
      ddc          = {610},
      cid          = {I:(DE-2719)1310010},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40975099},
      doi          = {10.1016/S1474-4422(25)00285-6},
      url          = {https://pub.dzne.de/record/281350},
}