Department of Neurology, Xuanwu Hospital, Capital Medical University.
Department of Radiology, Xuanwu Hospital, Capital Medical University.
J Atheroscler Thromb. 2019 Sep 1;26(9):792-804. doi: 10.5551/jat.47464. Epub 2019 Feb 6.
Coronary artery stenosis (CAS) ≥ 50% frequently coexists in patients with acute ischemic cerebrovascular disease (AICVD), which portends unfavorable outcomes. We sought to examine whether patients with AICVD with CAS had more severe and more diffused cervicocephalic atherosclerosis (CA).
Patients with AICVD were consecutively enrolled and underwent simultaneous computed tomography angiography (CTA) of the coronary and cervicocephalic arteries. A total of 140 patients were divided into "AICVD＋CAS" and "AICVD only" groups according to whether CTA showed stenosis of ≥ 50% in at least one coronary arterial segment. The relationship of the presence of CAS with the severity and extent of CA were examined.
The CA severity characteristics, including the presence of stenosis ≥ 50% and the grade of the most severe stenotic segment, were not significantly different between the two groups. Regarding the extent of CA, the presence of stenosis ≥ 50% in both sides (adjusted odds ratio [OR]: 4.29, 95% confidence interval [CI]: 1.67-10.98), both extracranial and intracranial (adjusted OR: 5.26, 95% CI: 2.24-12.35), both anterior and posterior circulation (adjusted OR: 5.29, 95% CI: 2.22-12.64), and the number of stenotic segments ≥ 50% in cervicocephalic arteries (adjusted OR: 1.58, 95% CI: 1.28-1.96) were associated with CAS in patients with AICVD, independently of clinical demographics and CA severity characteristics.
CA was similarly severe in patients with AICVD with and without CAS, but those with CAS had significantly more diffused CA. The extent of CA and CAS were mutual indicators in patients with AICVD, irrespective of CA severity.
急性缺血性脑血管病（AICVD）患者常伴有冠状动脉狭窄（CAS）≥50%，预后不良。本研究旨在探讨 AICVD 合并 CAS 患者是否存在更严重和更弥漫的颈脑血管粥样硬化（CA）。
连续纳入 AICVD 患者，并行冠状动脉和颈脑血管计算机断层血管造影（CTA）检查。根据 CTA 是否显示至少一个冠状动脉节段狭窄≥50%，将 140 例患者分为“合并 CAS 的 AICVD 组”和“单纯 AICVD 组”。检查了 CAS 的存在与 CA 的严重程度和范围的关系。
两组患者 CA 严重程度特征，包括狭窄≥50%的存在和最严重狭窄节段的程度，无显著差异。关于 CA 的范围，双侧狭窄≥50%（调整后比值比[OR]：4.29，95%置信区间[CI]：1.67-10.98）、颅内外（调整后 OR：5.26，95% CI：2.24-12.35）、前后循环（调整后 OR：5.29，95% CI：2.22-12.64）和颈脑血管狭窄≥50%的节段数（调整后 OR：1.58，95% CI：1.28-1.96）与 AICVD 患者的 CAS 独立相关，与临床人口统计学和 CA 严重程度特征无关。
AICVD 合并和不合并 CAS 的患者的 CA 严重程度相似，但合并 CAS 的患者的 CA 更弥漫。在 AICVD 患者中，CA 的程度和 CAS 是相互指示的，与 CA 的严重程度无关。
