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Co-existing cerebrovascular atherosclerosis predicts subsequent vascular event: a multi-contrast cardiovascular magnetic resonance imaging study.
- Source :
-
Journal of Cardiovascular Magnetic Resonance (BioMed Central) . 1/13/2020, Vol. 22 Issue 1, p1-9. 9p. 1 Black and White Photograph, 4 Charts, 1 Graph. - Publication Year :
- 2020
-
Abstract
- Background: It is still unknown that whether co-existing intracranial stenosis and extracranial carotid vulnerable plaques have higher predictive value for subsequent vascular events. This study aimed to determine the relationship between co-existing extracranial carotid vulnerable plaques and intracranial stenosis and subsequent vascular events utilizing cardiovascular magnetic resonance (CMR) vessel wall imaging. Methods: Patients who had recent cerebrovascular symptoms in anterior circulation (< 2 weeks) were consecutively enrolled and underwent multi-contrast CMR vessel wall imaging for extracranial carotid arteries and 3D time-of flight CMR angiography for intracranial arteries at baseline. After baseline examination, all patients were followed-up for at least 1 year to determined recurrence of vascular events. The co-existing cerebrovascular atherosclerosis was defined as presence of both intracranial artery stenosis and at least one the following measures of extracranial artery atherosclerosis: plaque, calcification, lipid-rich necrotic core (LRNC), or intraplaque hemorrhage. Univariate and multivariate Cox regressions were used to calculate the hazard ratio (HR) and corresponding 95% confidence interval (CI) of co-existing plaques in predicting subsequent vascular events. Results: In total, 150 patients (mean age: 61.8 ± 11.9 years; 109 males) were recruited. During the median follow-up time of 12.1 months, 41 (27.3%) patients experienced vascular events. Co-existing intracranial artery stenosis and extracranial carotid plaque (HR, 3.57; 95% CI, 1.63–7.82; P = 0.001) and co-existing intracranial artery stenosis and extracranial carotid LRNC (HR, 4.47; 95% CI, 2.15–9.27; P < 0.001) were significantly associated with subsequent vascular events, respectively. After adjusted for confounding factors and carotid stenosis, these associations remained statistically significant (HR, 5.12; 95% CI, 1.36–19.24; P = 0.016 and HR, 8.12; 95% CI, 2.41–27.31; P = 0.001, respectively). Conclusions: The co-existing cerebrovascular atherosclerotic diseases, particularly co-existing carotid lipid-rich necrotic core and intracranial stenosis, are independent predictors for subsequent vascular events. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CEREBROVASCULAR disease risk factors
*BLOOD vessels
*CAROTID artery
*CEREBRAL arteriosclerosis
*CEREBRAL circulation
*CONFIDENCE intervals
*DIAGNOSTIC imaging
*MAGNETIC resonance imaging
*COMPUTERS in medicine
*RISK assessment
*DISEASE relapse
*CONTRAST media
*PROPORTIONAL hazards models
*DESCRIPTIVE statistics
*MAGNETIC resonance angiography
CAROTID artery stenosis
Subjects
Details
- Language :
- English
- ISSN :
- 1532429X
- Volume :
- 22
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Journal of Cardiovascular Magnetic Resonance (BioMed Central)
- Publication Type :
- Academic Journal
- Accession number :
- 141168339
- Full Text :
- https://doi.org/10.1186/s12968-019-0596-6