Kamal Ayeesha Kamran, Majeed Farzin, Pasha Omrana, Rehman Hasan, Islam Muhammad, Azam Iqbal, Ilyas Muhammad Saleem, Hussain Munawar, Masood Kamran, Ahmed Bilal, Nazir Sumaira, Sajjad Zafar, Kasner Scott E
BMC Neurol. 2014 Aug 15;14:155. doi: 10.1186/s12883-014-0155-6.
Intracranial Atherosclerotic Disease (ICAD) is the most frequent etiology of stroke with high prevalence among Asians. Despite this, early determinants of ICAD have not been described from this region.
The study is an analytical prospective cross-sectional study of 200 adults from Radiology Departments of two diagnostic centers in Karachi. Eligible participants confirmed the absence of stroke symptoms via the Questionnaire for Verifying Stroke Free Status (QVSFS) and underwent an interview covering medical, socio demographic, lifestyle and anthropometric evaluation using locally validated and standardized definitions. Magnetic Resonance Images (MRI) were centrally reviewed to detect ICAD using the criterion used in the Warfarin-Aspirin Symptomatic Intracranial Disease study. The risk factors associated with asymptomatic ICAD are reported along with prevalence ratios.
Of the 200 participants, ICAD was found in 34.5% (n = 69) of the participants. Mean age was 37.1 (S.D 15.1) years with 62% younger than 45 years. Self-reported hypertension was found in 26.5% subjects, diabetes in 9%, dyslipidemia in 5% and depression in 60%. Smokeless tobacco (Adjusted PR 3.27 (1.07-6.05)), Western diet, high socioeconomic status (Adjusted PR 2.26 (1.99-5.62)) and dyslipidemia (Adjusted PR 1.88 (1.25-2.21)) had significant associations with ICAD after multivariable analysis. Age, gender, diabetes, hypertension, depression and physical activity did not have a significant association.
ICAD was found on MRI in one in three asymptomatic Pakistanis and was associated with modifiable risks. Initiatives targeting primary prevention may be able to decrease the burden of disease caused by stroke due to ICAD.
NCT02072876 2/25/2014.
颅内动脉粥样硬化性疾病（ICAD）是亚洲人中最常见的卒中病因，患病率很高。尽管如此，该地区尚未描述ICAD的早期决定因素。
本研究是一项分析性前瞻性横断面研究，对来自卡拉奇两个诊断中心放射科的200名成年人进行研究。符合条件的参与者通过无卒中状态验证问卷（QVSFS）确认无卒中症状，并接受了一次访谈，内容涵盖使用当地验证和标准化定义进行的医学、社会人口统计学、生活方式和人体测量学评估。使用华法林-阿司匹林有症状颅内疾病研究中使用的标准对磁共振成像（MRI）进行集中审查以检测ICAD。报告与无症状ICAD相关的危险因素以及患病率比。
在200名参与者中，34.5%（n = 69）的参与者发现有ICAD。平均年龄为37.1（标准差15.1）岁，62%的人年龄小于45岁。26.5%的受试者自述患有高血压，9%患有糖尿病，5%患有血脂异常，60%患有抑郁症。多变量分析后，无烟烟草（调整后PR 3.27（1.07 - 6.05））、西方饮食、高社会经济地位（调整后PR 2.26（1.99 - 5.62））和血脂异常（调整后PR 1.88（1.25 - 2.21））与ICAD有显著关联。年龄、性别、糖尿病、高血压、抑郁症和身体活动没有显著关联。
在三分之一无症状的巴基斯坦人中，MRI检查发现有ICAD，且与可改变的风险相关。针对一级预防的举措或许能够减轻ICAD所致卒中的疾病负担。
NCT02072876 2014年2月25日。
