Predicting asymptomatic coronary artery stenosis by aortic arch plaque in acute ischemic cerebrovascular disease: beyond the cervicocephalic atherosclerosis? / 中华医学杂志(英文版)
Chinese Medical Journal
; (24): 905-913, 2019.
Article
в En
| WPRIM
| ID: wpr-772177
Ответственная библиотека:
WPRO
ABSTRACT
BACKGROUND@#Asymptomatic coronary artery stenosis (ACAS) ≥50% is common in patients with acute ischemic cerebrovascular disease (AICVD), which portends a poor cardiovascular and cerebrovascular prognosis. Identifying ACAS ≥50% early may optimize the clinical management and improve the outcomes of these high-risk AICVD patients. This study aimed to investigate whether aortic arch plaque (AAP), an early atherosclerotic manifestation of brain blood-supplying arteries, could be a predictor for ACAS ≥50% in AICVD.@*METHODS@#In this cross-sectional study, atherosclerosis of the coronary and brain blood-supplying arteries was simultaneously evaluated using one-step computed tomography angiography (CTA) in AICVD patients without coronary artery disease history. The patients were divided into ACAS ≥50% and non-ACAS ≥50% groups according to whether CTA showed stenosis ≥50% in at least one coronary arterial segment. The AAP characteristics of CTA were depicted from aspects of thickness, extent, and complexity.@*RESULTS@#Among 118 analyzed patients with AICVD, 29/118 (24.6%) patients had ACAS ≥50%, while AAPs were observed in 86/118 (72.9%) patients. Increased AAP thickness per millimeter (adjusted odds ratio [OR] 1.56, 95% confidence interval [CI] 1.18-2.05), severe-extent AAP (adjusted OR 13.66, 95% CI 2.33-80.15), and presence of complex AAP (adjusted OR 7.27, 95% CI 2.30-23.03) were associated with ACAS ≥50% among patients with AICVD, independently of clinical demographics and cervicocephalic atherosclerotic stenosis. The combination of AAP thickness, extent, and complexity predicted ACAS ≥50% with an area under the receiver-operating characteristic curve of 0.78 (95% CI 0.70-0.85, P < 0.001). All three AAP characteristics provided additional predictive power beyond cervical and intracranial atherosclerotic stenosis for ACAS ≥50% in AICVD (all P < 0.05).@*CONCLUSIONS@#Thicker, severe-extent, and complex AAP were significant markers of the concomitant ACAS ≥50% in AICVD, possibly superior to the indicative value of cervical and intracranial atherosclerotic stenosis. As an integral part of atherosclerosis of brain blood-supplying arteries, AAP should not be overlooked in predicting ACAS ≥50% for patients with AICVD.
Полный текст:
1
База данных:
WPRIM
Основная тема:
Aorta, Thoracic
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Pathology
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Odds Ratio
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Cerebrovascular Disorders
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Cross-Sectional Studies
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Risk Factors
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Coronary Stenosis
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Diagnosis
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Plaque, Atherosclerotic
Тип исследования:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Пределы темы:
Aged
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Female
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Humans
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Male
Язык:
En
Журнал:
Chinese Medical Journal
Год:
2019
Тип:
Article