Incidence and prevalence of cerebral hemorrhage in patients with bicuspid aortic valve
5 affiliations
- 1Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ, USA; Corresponding author. Department of Cardiovascular Medicine . Mayo Clinic, Arizona, 13400 East Shea Boulevard, Scottsdale, AZ, , 85259, USA.
- 2Department of Medicine, Mayo Clinic, Jacksonville, FL, USA
- 3Department of Medicine, University of Arizona, Tucson, AZ, USA; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
- 4Department of Medicine, MedStar Georgetown, Baltimore, MD, USA
- 5Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ, USA
Abstract
Importance: Bicuspid aortic valve (BAV) is associated with aortopathy and an increased prevalence of intracranial aneurysms, but the burden of clinically recognized nontraumatic intracranial hemorrhage in this population is not well characterized. Methods: Retrospective descriptive cohort study using deidentified electronic health record data from the TriNetX Research Network. The study window extended from January 1, 2015, through December 31, 2024. The source query identified 48,582 patients with BAV and no prior aortic valve replacement across 54 health care organizations. The platform returned 45,802 patients for the prevalence analysis and 45,724 patients for the incidence risk set after excluding 78 patients with a prior recorded hemorrhage. The primary outcome was nontraumatic intracranial hemorrhage, defined by ICD-10-CM codes I60, I61, or I62. Incident cases were first recorded events during follow-up among patients without a prior event in the maximum available pre-index lookback. Incidence proportion, incidence rate per 1000 person-years, and period prevalence were estimated. Unadjusted sex-specific risk and rate ratios were calculated. Results: Hypertensive disease was documented in 26,120 patients (54%) and coarctation of the aorta in 3552 (7%). Total of 579 incident nontraumatic intracranial hemorrhages occurred, corresponding to an incidence proportion of 1.27% and an incidence rate of 1.68 per 1000 person-years. There were 657 prevalent cases (1.43%). Incidence was higher in males than females (1.44% vs 0.94%; risk ratio, 1.53 [95% CI, 1.27-1.84]; P < .001), and the male-to-female incidence rate ratio was 1.61 (95% CI, 1.34-1.94; P < .001). Incidence rates increased across older age strata. Conclusions and relevance: Nontraumatic intracranial hemorrhage represented a measurable component of morbidity among patients with BAV. These findings support further patient-level studies rather than causal attribution or routine neurovascular screening based on BAV alone.
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BibTeX
@article{ibrahim2026incidence,
title = {{Incidence and prevalence of cerebral hemorrhage in patients with bicuspid aortic valve}},
author = {Ramzi Ibrahim and Karam Albdour and Hoang Nhat Pham and Mohammad Abdallah Omar and Steven J. Lester and Said Alsidawi and Chadi Ayoub and Reza Arsanjani},
journal = {International Journal of Cardiology Congenital Heart Disease},
year = {2026},
month = sep,
doi = {10.1016/j.ijcchd.2026.100715},
url = {https://doi.org/10.1016/j.ijcchd.2026.100715},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Incidence and prevalence of cerebral hemorrhage in patients with bicuspid aortic valve
AU - Ramzi Ibrahim
AU - Karam Albdour
AU - Hoang Nhat Pham
AU - Mohammad Abdallah Omar
AU - Steven J. Lester
AU - Said Alsidawi
AU - Chadi Ayoub
AU - Reza Arsanjani
PY - 2026
DA - 2026/09/15
JO - International Journal of Cardiology Congenital Heart Disease
DO - 10.1016/j.ijcchd.2026.100715
UR - https://doi.org/10.1016/j.ijcchd.2026.100715
AB - Importance: Bicuspid aortic valve (BAV) is associated with aortopathy and an increased prevalence of intracranial aneurysms, but the burden of clinically recognized nontraumatic intracranial hemorrhage in this population is not well characterized. Methods: Retrospective descriptive cohort study using deidentified electronic health record data from the TriNetX Research Network. The study window extended from January 1, 2015, through December 31, 2024. The source query identified 48,582 patients with BAV and no prior aortic valve replacement across 54 health care organizations. The platform returned 45,802 patients for the prevalence analysis and 45,724 patients for the incidence risk set after excluding 78 patients with a prior recorded hemorrhage. The primary outcome was nontraumatic intracranial hemorrhage, defined by ICD-10-CM codes I60, I61, or I62. Incident cases were first recorded events during follow-up among patients without a prior event in the maximum available pre-index lookback. Incidence proportion, incidence rate per 1000 person-years, and period prevalence were estimated. Unadjusted sex-specific risk and rate ratios were calculated. Results: Hypertensive disease was documented in 26,120 patients (54%) and coarctation of the aorta in 3552 (7%). Total of 579 incident nontraumatic intracranial hemorrhages occurred, corresponding to an incidence proportion of 1.27% and an incidence rate of 1.68 per 1000 person-years. There were 657 prevalent cases (1.43%). Incidence was higher in males than females (1.44% vs 0.94%; risk ratio, 1.53 [95% CI, 1.27-1.84]; P < .001), and the male-to-female incidence rate ratio was 1.61 (95% CI, 1.34-1.94; P < .001). Incidence rates increased across older age strata. Conclusions and relevance: Nontraumatic intracranial hemorrhage represented a measurable component of morbidity among patients with BAV. These findings support further patient-level studies rather than causal attribution or routine neurovascular screening based on BAV alone.
SN - 2666-6685
ER -