Evidence map›Paper›PMID 34734206›Full record

ArticleThe Lancet regional health. Western Pacific2021

Natural history of silent lacunar infarction: 10-year follow-up of a community-based prospective study of 0.5 million Chinese adults.

Zilong Hao, Yiping Chen, Neil Wright, Haiqiang Qin, Iain Turnbull, Yu Guo, Christiana Kartsonaki, Sam Sansome, PeiPei, Canqing Yu and 8 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet regional health. Western Pacific, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Progression of enlarged perivascular spaces contributes to occurrence of silent lacunar infarction in the elderly.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024
    Article
  6. Observational
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Zilong HaoCenter of Cerebrovascular Disease, Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
Yiping ChenMedical Research Council Population Health Research Unit, (PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Neil WrightClinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Haiqiang QinChina National Clinical Research Centre for Neurological Disease; Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Iain TurnbullClinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Yu GuoChinese Academy of Medical Sciences, Dong Cheng District, Beijing, China.
Christiana KartsonakiMedical Research Council Population Health Research Unit, (PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Sam SansomeClinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
PeiPeiChinese Academy of Medical Sciences, Dong Cheng District, Beijing, China.
Canqing YuDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
Qijun GuTongxiang CDC, Tongxiang, Zhejiang, China.
Jianming HuShimen Town Health Center, Tongxiang, Zhejiang, China.
Jun LvDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
Liming LiDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
Ming LiuCenter of Cerebrovascular Disease, Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
Yongjun WangChina National Clinical Research Centre for Neurological Disease; Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Robert ClarkeClinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Zhengming ChenClinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.

Funding

Cancer Research UK 16896Cancer Research UK 29186Medical Research Council MC_U137686851Medical Research Council MC_UU_00017/1Medical Research Council MC_UU_12026/2Wellcome Trust 212946/Z/18/Z
6 · The paper itself

Abstract

backgroundWidespread use of brain imaging in China has resulted in an increased prevalence of silent lacunar infarct (LACI) in addition to symptomatic LACI, but their clinical relevance is not fully understood.

methodsWe compared the 5-year risks of recurrent stroke and all-cause mortality for silent LACI vs symptomatic LACI in a prospective study of 489,597 Chinese adults with no history of stroke or ischemic heart disease at baseline. Data on recurrent stroke and all-cause mortality were obtained by linkage with local stroke and mortality registries and health insurance records for all hospital admissions.

findingsAmong 12,150 cases with an adjudicated diagnosis of first-ever LACI, 4,134 (34%) had silent LACI and 8,016 (66%) had symptomatic LACI. All cases had brain imaging, but only 33% of silent LACI and 40% of symptomatic LACI cases had brain magnetic resonance imaging (MRI). The standardized event rates for silent LACI were 2-fold greater in urban than rural areas, but the ratios of silent LACI vs symptomatic LACI were similar in all areas. Cases with silent LACI vs symptomatic LACI had comparable 5-year risks of recurrent stroke (38% vs 43%) and all-cause mortality (11% vs 14%), respectively. For both silent and symptomatic LACI cases, most cases of recurrent stroke had non-LACI (70% vs 72%). While the relative risks of recurrent stroke did not differ by age, sex and area, the absolute risks of all-cause mortality varied by sex, age and area.

interpretationThe prognosis of cases with silent LACI was comparable with symptomatic LACI, and the results highlight the need for further randomized trials assessing the efficacy and safety of established treatments for ischemic stroke in cases with silent LACI.

fundingWellcome Trust (212946/Z/18/Z, 202922/Z/16/Z, 104085/Z/14/Z, 088158/Z/09/Z) and National Key Research and Development Program of China (2016YFC0900500, 2016YFC0900501, 2016YFC0900504, 2016YFC1303904) and National Natural Science Foundation of China (91843302); UK Medical Research Council (MC_UU_00017/1,MC_UU_12026/2 MC_U137686851), Cancer Research UK (C16077/A29186; C500/A16896) and British Heart Foundation (CH/1996001/9454). ZH was supported West China Hospital, Sichuan University (ZYGD18009 and 2016YFC1300505) for a visiting scholarship to the University of Oxford, UK, during 2018-19.

Indexed as

Cerebral small vessel diseasePrognosisSilent lacunar infarctionStroke subtypes

Identifiers

PMID34734206
PMCPMC8551852

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.