Atherosclerosis Burden of Brain‐ and Heart‐Supplying Arteries and the Relationship With Vascular Risk in Patients With Ischemic Stroke
Background Atherosclerosis of brain‐ and heart‐supplying arteries (BHAs) are risk indicators for patients with ischemic stroke, but the atherosclerosis burden (AB) of intracranial, cervical, aortic, and coronary arteries in each and in total have not been simultaneously evaluated, and the associatio...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.029505 |
| _version_ | 1797743190818684928 |
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| author | Qi Kong Xin Ma Luguang Li Chen Wang Xiangying Du Yungao Wan |
| author_facet | Qi Kong Xin Ma Luguang Li Chen Wang Xiangying Du Yungao Wan |
| author_sort | Qi Kong |
| collection | DOAJ |
| description | Background Atherosclerosis of brain‐ and heart‐supplying arteries (BHAs) are risk indicators for patients with ischemic stroke, but the atherosclerosis burden (AB) of intracranial, cervical, aortic, and coronary arteries in each and in total have not been simultaneously evaluated, and the associations with vascular risk remain unknown. Methods and Results With computed tomography angiography, single‐territory AB was triple ranked on the basis of the number of arterial segments with a significant atherosclerotic lesion. The total AB (TAB) of BHAs was triple ranked on the basis of the number of arterial territories with a significant atherosclerotic lesion, or according to the sum of 4 single‐territory AB rank‐scores. After a 12‐month follow‐up of 395 patients with ischemic stroke, a composite outcome of ischemic stroke, myocardial infarction, and vascular death occurred in 10.9%. The single‐territory AB of intracranial, cervical, aortic, and coronary arteries showed distinct strata patterns and different associations with vascular risk. The score‐based TAB of BHAs predicted vascular risk (crude hazard ratios [95% CIs]: per level increase, 2.35 [1.54–3.58]; median versus low, 3.37 [1.45–7.82]; high versus low, 6.00 [2.36–15.24]) independently of vascular risk factors and single‐territory AB, providing more prognostic information than the TAB of BHAs measured by the number of significantly atherosclerotic territories. Vascular events occurred in 3.0%, 13.6%, and 22.6% of patients in the low (41.8%), median (44.8%), and high (13.4%) strata of the score‐based TAB of BHAs, respectively. Conclusions The single‐territory AB of intracranial, cervical, aortic, or coronary arteries might be not reliable for vascular risk stratification in patients with ischemic stroke, and evaluating the TAB of BHAs by quantitatively integrating the single‐territory AB is advisable. |
| first_indexed | 2024-03-12T14:51:58Z |
| format | Article |
| id | doaj.art-af7f2fe6760b456cb4efd6ce5e8a0408 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-12T14:51:58Z |
| publishDate | 2023-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-af7f2fe6760b456cb4efd6ce5e8a04082023-08-15T12:07:43ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802023-08-01121610.1161/JAHA.123.029505Atherosclerosis Burden of Brain‐ and Heart‐Supplying Arteries and the Relationship With Vascular Risk in Patients With Ischemic StrokeQi Kong0Xin Ma1Luguang Li2Chen Wang3Xiangying Du4Yungao Wan5Department of Neurology, Xuanwu Hospital Capital Medical University Beijing ChinaDepartment of Neurology, Xuanwu Hospital Capital Medical University Beijing ChinaDepartment of Neurology, Xuanwu Hospital Capital Medical University Beijing ChinaDepartment of Radiology, Xuanwu Hospital Capital Medical University Beijing ChinaNational Clinical Research Center for Geriatric Disorders Beijing ChinaClinical Center for Cardio‐Cerebrovascular Disease of Capital Medical University Beijing ChinaBackground Atherosclerosis of brain‐ and heart‐supplying arteries (BHAs) are risk indicators for patients with ischemic stroke, but the atherosclerosis burden (AB) of intracranial, cervical, aortic, and coronary arteries in each and in total have not been simultaneously evaluated, and the associations with vascular risk remain unknown. Methods and Results With computed tomography angiography, single‐territory AB was triple ranked on the basis of the number of arterial segments with a significant atherosclerotic lesion. The total AB (TAB) of BHAs was triple ranked on the basis of the number of arterial territories with a significant atherosclerotic lesion, or according to the sum of 4 single‐territory AB rank‐scores. After a 12‐month follow‐up of 395 patients with ischemic stroke, a composite outcome of ischemic stroke, myocardial infarction, and vascular death occurred in 10.9%. The single‐territory AB of intracranial, cervical, aortic, and coronary arteries showed distinct strata patterns and different associations with vascular risk. The score‐based TAB of BHAs predicted vascular risk (crude hazard ratios [95% CIs]: per level increase, 2.35 [1.54–3.58]; median versus low, 3.37 [1.45–7.82]; high versus low, 6.00 [2.36–15.24]) independently of vascular risk factors and single‐territory AB, providing more prognostic information than the TAB of BHAs measured by the number of significantly atherosclerotic territories. Vascular events occurred in 3.0%, 13.6%, and 22.6% of patients in the low (41.8%), median (44.8%), and high (13.4%) strata of the score‐based TAB of BHAs, respectively. Conclusions The single‐territory AB of intracranial, cervical, aortic, or coronary arteries might be not reliable for vascular risk stratification in patients with ischemic stroke, and evaluating the TAB of BHAs by quantitatively integrating the single‐territory AB is advisable.https://www.ahajournals.org/doi/10.1161/JAHA.123.029505atherosclerosis burdenbrain‐ and heart‐supplying arteriesischemic strokevascular risk |
| spellingShingle | Qi Kong Xin Ma Luguang Li Chen Wang Xiangying Du Yungao Wan Atherosclerosis Burden of Brain‐ and Heart‐Supplying Arteries and the Relationship With Vascular Risk in Patients With Ischemic Stroke Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease atherosclerosis burden brain‐ and heart‐supplying arteries ischemic stroke vascular risk |
| title | Atherosclerosis Burden of Brain‐ and Heart‐Supplying Arteries and the Relationship With Vascular Risk in Patients With Ischemic Stroke |
| title_full | Atherosclerosis Burden of Brain‐ and Heart‐Supplying Arteries and the Relationship With Vascular Risk in Patients With Ischemic Stroke |
| title_fullStr | Atherosclerosis Burden of Brain‐ and Heart‐Supplying Arteries and the Relationship With Vascular Risk in Patients With Ischemic Stroke |
| title_full_unstemmed | Atherosclerosis Burden of Brain‐ and Heart‐Supplying Arteries and the Relationship With Vascular Risk in Patients With Ischemic Stroke |
| title_short | Atherosclerosis Burden of Brain‐ and Heart‐Supplying Arteries and the Relationship With Vascular Risk in Patients With Ischemic Stroke |
| title_sort | atherosclerosis burden of brain and heart supplying arteries and the relationship with vascular risk in patients with ischemic stroke |
| topic | atherosclerosis burden brain‐ and heart‐supplying arteries ischemic stroke vascular risk |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.029505 |
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