Population Health Research Institute, Hamilton Health Sciences, McMaster University, 237 Barton St East, Hamilton, Ontario L8L 2X2, Canada.
Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada.
Eur Heart J Cardiovasc Imaging. 2020 Jun 1;21(6):692-700. doi: 10.1093/ehjci/jez226.
Cardiovascular risk factors are used for risk stratification in primary prevention. We sought to determine if simple cardiac risk scores are associated with magnetic resonance imaging (MRI)-detected subclinical cerebrovascular disease including carotid wall volume (CWV), carotid intraplaque haemorrhage (IPH), and silent brain infarction (SBI).
A total of 7594 adults with no history of cardiovascular disease (CVD) underwent risk factor assessment and a non-contrast enhanced MRI of the carotid arteries and brain using a standardized protocol in a population-based cohort recruited between 2014 and 2018. The non-lab-based INTERHEART risk score (IHRS) was calculated in all participants; the Framingham Risk Score was calculated in a subset who provided blood samples (n = 3889). The association between these risk scores and MRI measures of CWV, carotid IPH, and SBI was determined. The mean age of the cohort was 58 (8.9) years, 55% were women. Each 5-point increase (∼1 SD) in the IHRS was associated with a 9 mm3 increase in CWV, adjusted for sex (P < 0.0001), a 23% increase in IPH [95% confidence interval (CI) 9-38%], and a 32% (95% CI 20-45%) increase in SBI. These associations were consistent for lacunar and non-lacunar brain infarction. The Framingham Risk Score was also significantly associated with CWV, IPH, and SBI. CWV was additive and independent to the risk scores in its association with IPH and SBI.
Simple cardiovascular risk scores are significantly associated with the presence of MRI-detected subclinical cerebrovascular disease, including CWV, IPH, and SBI in an adult population without known clinical CVD.
心血管危险因素用于一级预防的风险分层。我们旨在确定简单的心脏风险评分是否与磁共振成像（MRI）检测到的亚临床脑血管疾病相关，包括颈动脉壁体积（CWV）、颈动脉斑块内出血（IPH）和无症状性脑梗死（SBI）。
在 2014 年至 2018 年间，一项基于人群的队列研究中，共有 7594 名无心血管疾病（CVD）病史的成年人接受了危险因素评估和颈动脉及脑部非增强 MRI 检查，使用标准化方案。所有参与者均计算了非实验室基于的 INTERHEART 风险评分（IHRS）；在提供血液样本的亚组中计算了 Framingham 风险评分（n=3889）。确定这些风险评分与 MRI 测量的 CWV、颈动脉 IPH 和 SBI 之间的关联。队列的平均年龄为 58（8.9）岁，55%为女性。在调整性别后，IHRS 每增加 5 分（约 1 个标准差），CWV 增加 9 立方毫米（P<0.0001），IPH 增加 23%[95%置信区间（CI）9-38%]，SBI 增加 32%（95%CI 20-45%）。这些关联在腔隙性和非腔隙性脑梗死中是一致的。Framingham 风险评分也与 CWV、IPH 和 SBI 显著相关。在与 IPH 和 SBI 的关联中，CWV 与风险评分具有加性和独立性。
在无已知临床 CVD 的成年人群中，简单的心血管风险评分与 MRI 检测到的亚临床脑血管疾病（包括 CWV、IPH 和 SBI）的存在显著相关。
