Department of Neurology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea.
Department of Neurology, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea.
Eur J Neurol. 2020 May;27(5):793-799. doi: 10.1111/ene.14155. Epub 2020 Feb 14.
In 2013, the American College of Cardiology/American Heart Association (ACC/AHA) introduced a novel pooled cohort risk (PCR) model for atherosclerotic cardiovascular disease. In this study, we evaluated the relationship between the PCR score and cerebral large- and small-vessel diseases (cLVD and cSVD) in a healthy population, METHODS: We assessed consecutive health check-up volunteers from 2006 to 2013. We calculated the estimated 10-year atherosclerotic cardiovascular disease risk as the PCR score based on the 2013 ACC/AHA guidelines. We evaluated both cSVD/cLVD, including the prevalence of cLVD, lacunes and cerebral microbleed (CMB), and the volume of white matter hyperintensity (WMH). In addition to PCR score, the risk factors that were associated with outcome variables at P < 0.10 in univariate analysis were included for further multivariable linear or regression analyses.
A total of 2720 participants were evaluated (mean age, 57 years, male sex, 54%). In multivariable analysis, PCR score was associated with WMH volume [β = 0.361; 95% confidence interval (CI), 0.320-0.402, P < 0.001], cLVD [adjusted odds ratio (aOR), 1.66; 95% CI, 1.29-2.16, P < 0.001], lacunes (aOR, 1.80; 95% CI, 1.52-2.14, P < 0.001) and CMBs (aOR, 1.75; 95% CI, 1.40-2.19, P < 0.001). Furthermore, PCR score also showed dose-response tendencies according to the burden of cLVD, WMH, lacunes and CMB.
A higher PCR score based on the ACC/AHA guidelines is closely associated with a higher prevalence and burden of cLVD and cSVD.
2013 年，美国心脏病学会/美国心脏协会（ACC/AHA）引入了一种新型的动脉粥样硬化性心血管疾病 pooled cohort risk（PCR）模型。本研究旨在评估该 PCR 评分与健康人群的大脑大血管和小血管疾病（cLVD 和 cSVD）之间的关系。
我们评估了 2006 年至 2013 年期间连续的健康体检志愿者。我们根据 2013 年 ACC/AHA 指南计算了估计的 10 年动脉粥样硬化性心血管疾病风险，即 PCR 评分。我们评估了 cSVD/cLVD，包括 cLVD 的患病率、腔隙和脑微出血（CMB）以及脑白质高信号（WMH）体积。除 PCR 评分外，单变量分析中与结局变量相关的 P<0.10 的危险因素也被纳入进一步的多变量线性或回归分析。
共评估了 2720 名参与者（平均年龄 57 岁，男性占 54%）。多变量分析显示，PCR 评分与 WMH 体积相关[β=0.361；95%置信区间（CI）：0.320-0.402，P<0.001]、cLVD[校正优势比（aOR），1.66；95%CI：1.29-2.16，P<0.001]、腔隙（aOR，1.80；95%CI：1.52-2.14，P<0.001）和 CMB（aOR，1.75；95%CI：1.40-2.19，P<0.001）。此外，PCR 评分还显示出与 cLVD、WMH、腔隙和 CMB 负担的剂量反应趋势。
基于 ACC/AHA 指南的较高 PCR 评分与较高的 cLVD 和 cSVD 患病率和负担密切相关。
