From the Department of Neurology, Gangnam Severance Hospital (B.-H.C., J.H.K., J.K., K.-Y.L.), Yonsei University College of Medicine, Seoul, Korea.
Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul (B.-H.C.).
Stroke. 2019 Jun;50(6):1403-1408. doi: 10.1161/STROKEAHA.119.024726. Epub 2019 May 14.
Background and Purpose- Several vascular risk factors are known to be associated with the occurrence of intracranial aneurysms (IAs). Coronary artery calcium (CAC), which reflects the atherosclerotic burden of the coronary arteries, is a known predictor of cardiovascular events and stroke. We investigated the relationship between IA and CAC. Methods- We retrospectively enrolled Korean subjects at a single university hospital who had both brain magnetic resonance angiography and cardiac computed tomography as part of health examinations from January 2010 to July 2017. Subjects were categorized into 4 groups according to CAC score as assessed by cardiac computed tomography: zero (0), low (1-99), intermediate (100-399), or high (≥400). Then, the prevalence of IA in each CAC score group was assessed. We also performed subgroup analysis by age, sex, and location of IA. Results- A total of 4934 subjects (mean age, 54.1±9.8 years; %women, 42.2%) were included for analysis. IAs were detected in 258 subjects (5.23%). The prevalence of IA significantly increased as the CAC score increased (4.8%, 5.4%, 6.4%, and 11.1%, respectively; P for trend, 0.004). In subjects over the age of 50 years, this correlation was more prominent in women than in men (7.1% versus 3.7%, 8.8% versus 4.4%, 8.6% versus 6.3%, and 21.1% versus 10.0%, respectively). Subgroup analysis for the aneurysm location showed that nonbifurcation aneurysm was associated with a high CAC score but bifurcation aneurysm was not. Multivariate logistic regression showed high CAC score was an independent risk factor for the presence of IA compared with zero CAC score (adjusted odds ratio, 2.16; 95% CI, 1.18-3.95). Conclusions- A high CAC score was associated with the presence of IA. This relationship was more prominent in females and nonbifurcation aneurysms.
背景与目的- 已知多种血管危险因素与颅内动脉瘤(IA)的发生有关。冠状动脉钙(CAC)反映了冠状动脉的动脉粥样硬化负担,是心血管事件和中风的已知预测指标。我们研究了 IA 与 CAC 之间的关系。方法- 我们回顾性地纳入了 2010 年 1 月至 2017 年 7 月期间在一家大学医院接受脑磁共振血管造影和心脏计算机断层扫描检查作为健康检查一部分的韩国受试者。根据心脏计算机断层扫描评估的 CAC 评分,将受试者分为 4 组:0(0)、低(1-99)、中(100-399)或高(≥400)。然后,评估每个 CAC 评分组中 IA 的患病率。我们还按年龄、性别和 IA 位置进行了亚组分析。结果- 共纳入 4934 名受试者(平均年龄 54.1±9.8 岁;女性占 42.2%)进行分析。258 名受试者(5.23%)检出 IA。IA 的患病率随着 CAC 评分的增加而显著增加(分别为 4.8%、5.4%、6.4%和 11.1%;趋势 P 值<0.004)。在 50 岁以上的受试者中,这种相关性在女性中比男性更为明显(分别为 7.1%比 3.7%、8.8%比 4.4%、8.6%比 6.3%和 21.1%比 10.0%)。对于动脉瘤位置的亚组分析表明,非分叉动脉瘤与高 CAC 评分相关,而分叉动脉瘤则不然。多变量逻辑回归显示,与 CAC 评分零相比,高 CAC 评分是 IA 存在的独立危险因素(调整后的优势比,2.16;95%置信区间,1.18-3.95)。结论- 高 CAC 评分与 IA 的存在相关。这种关系在女性和非分叉动脉瘤中更为明显。