Kong Qi, Ma Xin, Wang Chen, Feng Wuwei, Ovbiagele Bruce, Zhang Yuren, Du Xiangying, Fang Xianghua
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
J Stroke Cerebrovasc Dis. 2019 Jun;28(6):1586-1596. doi: 10.1016/j.jstrokecerebrovasdis.2019.03.001. Epub 2019 Mar 28.
Complex aortic plaque is a potential cause of acute ischemic cerebrovascular disease, which needs timely identification. Also as a marker for systemic atherosclerosis, complex aortic plaque may be indicated by significant (≥50%) cervicocephalic atherosclerotic stenosis. We aimed at examining whether age ranges would influence their association to more accurately estimate the risk of having complex aortic plaque in acute ischemic cerebrovascular disease.
Aortic arch and cervicocephalic arteries were simultaneously evaluated using computed tomography angiography. Middle-aged (45-64 years) and old-aged (65-85 years) acute ischemic cerebrovascular disease patients were divided into 2 groups according to whether there was an aortic arch plaque with thickness of greater than or equal to 4 mm or associated ulcerations or mural thrombus.
Old-aged patients (n = 107) had a higher prevalence of complex aortic plaque (67.3% versus 30.9%, P < .001) than those middle aged (n = 178). Among middle-aged patients, the presence of extracranial significant atherosclerotic stenosis (adjusted odd ratio = 2.89, 95% confidence interval: 1.42-5.86) rather than intracranial ones independently predicted complex aortic plaque. Regarding the extent of significant cervicocephalic atherosclerotic stenosis, the presence of multi-segment, bilateral, simultaneous extracranial and intracranial, and simultaneous anterior and posterior circulation ones were independent indicators for complex aortic plaque in the middle-aged subgroup (adjusted odd ratio = 2.42, 2.05, 2.26, 2.14, respectively). By contrast, no statistical correlation of complex aortic plaque and significant cervicocephalic atherosclerotic stenosis was found among old-aged patients.
Considering the ranges of age was important to more precisely predict complex aortic plaque with significant cervicocephalic atherosclerotic stenosis in acute ischemic cerebrovascular disease.
复杂主动脉斑块是急性缺血性脑血管病的潜在病因，需要及时识别。作为全身动脉粥样硬化的一个标志物，复杂主动脉斑块可能由显著（≥50%）的颈脑动脉粥样硬化狭窄所提示。我们旨在研究年龄范围是否会影响它们之间的关联，以便更准确地评估急性缺血性脑血管病患者出现复杂主动脉斑块的风险。
采用计算机断层血管造影术同时评估主动脉弓和颈脑动脉。将中年（45 - 64岁）和老年（65 - 85岁）急性缺血性脑血管病患者根据是否存在厚度大于或等于4 mm的主动脉弓斑块或相关溃疡或壁内血栓分为两组。
老年患者（n = 107）复杂主动脉斑块的患病率（67.3%对30.9%，P <.001）高于中年患者（n = 178）。在中年患者中，颅外显著动脉粥样硬化狭窄（校正比值比 = 2.89，95%置信区间：1.42 - 5.86）而非颅内显著动脉粥样硬化狭窄独立预测复杂主动脉斑块。关于显著颈脑动脉粥样硬化狭窄的范围，多节段、双侧、同时存在颅外和颅内以及同时存在前循环和后循环的情况是中年亚组中复杂主动脉斑块的独立指标（校正比值比分别为2.42、2.05、2.26、2.14）。相比之下，老年患者中复杂主动脉斑块与显著颈脑动脉粥样硬化狭窄之间未发现统计学相关性。
考虑年龄范围对于更精确地预测急性缺血性脑血管病中伴有显著颈脑动脉粥样硬化狭窄的复杂主动脉斑块很重要。
