Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia.
Department of Epidemiology, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia.
BMC Neurosci. 2021 Jan 21;22(1):3. doi: 10.1186/s12868-021-00609-4.
Circle of Willis is the main structure that provides constant and regular blood flow to the brain, protects the brain from ischemia. Stroke has remained the second leading cause of death globally in the last fifteen years. It is the fifth leading cause of death in the United States. It is also the leading cause of serious adult disability. Interlinked problems related to ischemic stroke are become increasing nowadays. Strong evidence is needed about the pooled measure of association between the circle of Willis (COW) and ischemic stroke. Therefore, this systematic review and meta-analysis were intended to provide compressive and up to date evidence on the association between the variations of COW and ischemic stroke using the available studies.
PubMed, Google Scholar, Science Direct, and Cochrane Library databases were systematically searched. All essential data were extracted using a standardized data extraction template. The heterogeneity across studies was assessed by using the Cochrane Q test statistic, I test statistic, and P-values. A fixed-effect model was used to estimate the pooled effect of the measure association between COW and ischemic stroke.
In this meta-analysis, 2,718 participants were involved. The pooled measure of association between COW and ischemic stroke was 1.38 (95% CI 0.87, 2.19). Therefore, this indicated that the presence of any variation in COW was 1.38 times more likely to develop ischemic stroke as compared to the patent COW. The presence of hypoplasia/incompleteness in a posterior communicating artery (PcomA) [Pooled OR: 1.34 (95% CI 0.80, 2.25)] and anterior communicating artery (AcomA) [Pooled OR: 1.32 (95% CI 0.81, 2.19)] were a contributing factor for the development of ischemic stroke. Hypertension was the most common comorbid condition, followed by diabetes mellitus, smoking, coronary artery disease, and hyperlipidemia.
There was a non-significant positive association between COW variation and ischemic stroke in this meta-analysis.
Willis 环是为大脑提供持续稳定血流、保护大脑免受缺血的主要结构。在过去的十五年中，中风一直是全球第二大致死原因。它也是美国第五大致死原因，也是导致严重成年人残疾的主要原因。与缺血性中风相关的相互关联的问题如今变得越来越多。需要强有力的证据来证明 Willis 环（COW）与缺血性中风之间的关联的汇总衡量标准。因此，本系统评价和荟萃分析旨在提供关于使用现有研究评估 COW 变异与缺血性中风之间关联的综合和最新证据。
系统检索了 PubMed、Google Scholar、Science Direct 和 Cochrane Library 数据库。使用标准化数据提取模板提取所有必要数据。使用 Cochrane Q 检验统计量、I 检验统计量和 P 值评估研究之间的异质性。使用固定效应模型估计 COW 与缺血性中风之间关联的汇总效应。
在这项荟萃分析中，涉及 2718 名参与者。COW 与缺血性中风之间的汇总关联度量为 1.38（95%CI 0.87，2.19）。因此，这表明 COW 任何变异的存在发生缺血性中风的可能性是 COW 正常的 1.38 倍。后交通动脉（PcomA）[汇总 OR：1.34（95%CI 0.80，2.25）]和前交通动脉（AcomA）[汇总 OR：1.32（95%CI 0.81，2.19）]发育不全/不完整是缺血性中风发展的一个促成因素。高血压是最常见的合并症，其次是糖尿病、吸烟、冠心病和高脂血症。
在这项荟萃分析中，COW 变异与缺血性中风之间存在非显著正相关。
