Del Brutto Oscar H, Mera Robertino M, Lama Julio, Zambrano Mauricio, Del Brutto Victor J
School of Medicine, Universidad Espíritu Santo - Ecuador, Guayaquil, Ecuador; Department of Neurological Sciences, Hospital-Clínica Kennedy, Guayaquil 0901, Ecuador.
Gastroenterology Department, Vanderbilt University, Nashville, TN, USA.
Arch Gerontol Geriatr. 2015 Nov-Dec;61(3):480-3. doi: 10.1016/j.archger.2015.08.011. Epub 2015 Aug 11.
Intracranial arterial stenosis (IAS) is more prevalent among Asians, Blacks and Caribbean Hispanics than in Whites. However, there is no information on the importance of this common cause of stroke among Mestizo/Native populations of Latin America. We aimed to assess prevalence and correlates of IAS in an indigenous Ecuadorian population of older adults.
Atahualpa residents aged ≥60 years were identified during door-to-door surveys and invited to undergo brain magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) of intracranial vessels for identification of stroke lesions and arterial stenosis. Prevalence of IAS was assessed in patients with strokes as well as in stroke-free individuals. A logistic regression model was constructed with stroke as the outcome, IAS as the exposure, and confounders (demographics and cardiovascular risk factors) as independent variables.
Out of 267 participants (mean age 71 ± 8 years, 57% women), 15 (5.6%) had intracranial arterial stenosis, including 10 out of 52 (19.2%) persons with stroke and five out of 215 (2.3%) without. The multivariate logistic regression model showed significant association of IAS with stroke after adjusting for demographics and cardiovascular risk factors (OR: 7.9, 95% C.I.: 2.2-27.8, p=0.001). Mechanisms underlying stroke in patients with IAS included perforator occlusion, artery-to-artery embolism and hypoperfusion.
Prevalence of IAS in Ecuadorian Natives/Mestizos is similar to that in Asians. Individuals aged ≥60 years with IAS are almost eight times more likely to have a stroke after adjusting for confounding variables.
颅内动脉狭窄（IAS）在亚洲人、黑人和加勒比西班牙裔中比在白人中更为普遍。然而，关于这一常见中风病因在拉丁美洲混血/原住民人群中的重要性尚无相关信息。我们旨在评估厄瓜多尔老年原住民人群中IAS的患病率及其相关因素。
通过挨家挨户调查确定年龄≥60岁的阿塔瓦尔帕居民，并邀请他们接受颅内血管的脑磁共振成像（MRI）和磁共振血管造影（MRA）检查，以识别中风病灶和动脉狭窄。在中风患者以及无中风个体中评估IAS的患病率。构建以中风为结局、IAS为暴露因素、混杂因素（人口统计学和心血管危险因素）为自变量的逻辑回归模型。
在267名参与者（平均年龄71±8岁，57%为女性）中，15人（5.6%）患有颅内动脉狭窄，其中52名中风患者中有10人（19.2%），215名无中风患者中有5人（2.3%）。多变量逻辑回归模型显示，在调整人口统计学和心血管危险因素后，IAS与中风存在显著关联（比值比：7.9，95%置信区间：2.2 - 27.8，p = 0.001）。IAS患者中风的潜在机制包括穿支闭塞、动脉到动脉栓塞和低灌注。
厄瓜多尔原住民/混血人群中IAS的患病率与亚洲人相似。在调整混杂变量后，年龄≥60岁的IAS患者发生中风的可能性几乎高出七倍。
