Cui Xiaoyang, Li Yi, Liu Junfeng, He Sha, Liu Ming
Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, China.
J Evid Based Med. 2014 Aug;7(3):185-91. doi: 10.1111/jebm.12113.
Epidemiological studies have suggested that aortic atheroma may play a role in cerebral embolization; however, no meta-analysis was conducted to evaluate the relationship between aortic atheroma and risk of stroke. The aim of this study was to investigate the association between the presence of aortic atheroma and risk of stroke.
We performed a comprehensive search of observational studies reporting the relationship between the presence of aortic atheroma and stroke using the PubMed, EMbase, the China National Knowledge Infrastructure database (CNKI), Chinese Technical Periodicals (VIP), and WanFang Data databases. Two reviewers independently assessed the eligibility and extracted data from the included studies. We performed the meta-analysis to estimate the strength of the association according to Meta-analysis of Observational Studies in Epidemiology (MOOSE) guideline and assessed the study quality by the Newcastle-Ottawa Scale (NOS).
We identified 12 eligible studies with 3918 participants. The scores of the NOS of the included studies ranged from 5 to 9. The pooled estimate of strength of the association between the presence of aortic atheroma and stroke was statistical significant (OR = 3.93, 95%CI 2.86 to 5.40). In subgroup analysis according to plaques' morphology, complex aortic atheroma had significantly higher (OR = 5.90, 95%CI 4.14 to 8.41) risk of stroke than protruding atheroma (OR = 3.75, 95%CI 3.05 to 4.61).
This study indicated that aortic atheroma significantly increased the risk of stroke by about four times. Patients with complex aortic atheroma have a higher risk of stroke than protruding atheroma.
流行病学研究表明主动脉粥样硬化可能在脑栓塞中起作用；然而，尚未进行荟萃分析来评估主动脉粥样硬化与中风风险之间的关系。本研究的目的是探讨主动脉粥样硬化的存在与中风风险之间的关联。
我们使用PubMed、EMbase、中国知网数据库（CNKI）、维普中文科技期刊数据库（VIP）和万方数据库，对报告主动脉粥样硬化的存在与中风之间关系的观察性研究进行了全面检索。两名审阅者独立评估纳入研究的合格性并提取数据。我们根据《流行病学观察性研究的荟萃分析》（MOOSE）指南进行荟萃分析以估计关联强度，并通过纽卡斯尔-渥太华量表（NOS）评估研究质量。
我们确定了12项合格研究，共3918名参与者。纳入研究的NOS评分范围为5至9分。主动脉粥样硬化的存在与中风之间关联强度的合并估计具有统计学意义（OR = 3.93，95%CI为2.86至5.40）。在根据斑块形态进行的亚组分析中，复杂性主动脉粥样硬化的中风风险显著高于突出性粥样硬化（OR = 5.90，95%CI为4.14至8.41）（OR = 3.75，95%CI为3.05至4.61）。
本研究表明主动脉粥样硬化使中风风险显著增加约四倍。患有复杂性主动脉粥样硬化的患者比患有突出性粥样硬化的患者中风风险更高。
