Do amyloid cerebral deposits influence the long-term post-stroke cognitive outcome? The IDEA3 study

BackgroundAlthough the presence of amyloid deposits is associated with a more severe cognitive status in stroke patients at baseline, its influence on the subsequent cognitive outcome has not been extensively assessed. The primary objective of the present study of the IDEA3 cohort was to determine the influence of amyloid PET status on the 5-year cognitive outcome. MethodsThe 91 stroke patients (ischemic stroke: 89%; hemorrhagic stroke: 11%) with florbetapir PET data at baseline (positive: n=14) underwent comprehensive clinical and cognitive assessments for 5 years after the PET scan. ResultsA survival analysis (mean post-stroke follow-up: 80.4 {+/-}27 months) showed that the incidence of dementia was higher in the PET-positive patients (OR=5.89, 95% CI: 1.24-22.7, p=0.02), as was the incidence of cognitive impairment (OR=10, 95% CI: 1.9-52.3, p=0.003). A Cox regression analysis showed that the association between amyloid status and the incidences of dementia (p=0.006) and CI (p=0.04) was still significant after adjustment for age. Considering the overall prevalence at last follow-up in the whole study population (n=91 patients), PET positivity was associated with an elevated risk of post-stroke cognitive impairment (OR=6.25, 95%CI: 1.77-22, p=0.002) or dementia (OR= 6, 95%CI: 1.76-20.5, p=0.002). The final Rankin score did not differ according to PET status (p=0.3). ConclusionsOur results demonstrated the major impact of amyloid deposition on the stroke outcome and emphasized the need for comprehensive etiologic work-up in patients with post-stroke cognitive impairment. Clinical Trial RegistrationNCT 02813434