Department of Surgery, Turku University Hospital and University of Turku, Turku, Finland.
Department of Surgery, Turku University Hospital and University of Turku, Turku, Finland.
Atherosclerosis. 2021 Oct;334:30-38. doi: 10.1016/j.atherosclerosis.2021.08.027. Epub 2021 Aug 15.
Patients with intracranial aneurysms (IA) have excess mortality for cardiovascular diseases, but little is known on whether atherosclerotic manifestations and IA coexist. We investigated abdominal aortic calcification index (ACI) association with unruptured and ruptured IAs.
This retrospective case-control study reviews all tertiary centers patients (n = 24,660) who had undergone head computed tomography angiography (CTA), magnetic resonance angiography (MRA) or digital subtraction angiography (DSA) for any reason between January 2003 and May 2018. Patients (n = 2020) with unruptured or ruptured IAs were identified, and patients with available abdominal CT were included. IA patients were matched by sex and age to controls (available abdomen CT, no IAs) in ratio of 1:3. ACI was measured from abdomen CT scans and patient records were reviewed.
1720 patients (216 ruptured IA (rIA), 246 unruptured IA (UIA) and 1258 control) were included. Mean age was 62.9 ± 11.9 years and 58.2% were female. ACI (OR 1.02 per increment, 95%CI 1.01-1.03) and ACI>3 (OR 5.77, 95%CI 3.29-10.11) increased risk for rIA compared to matched controls. UIA patients' ACI was significantly higher but ACI did not increase odds for UIA compared to matched controls. History of coronary artery disease was less frequent in rIA patients. There was no calcification in aorta in 8.8% rIA and 13.6% UIA patients (matched controls 25.7% and 22.6% respectively, p < 0.01).
Aortic calcification is greater in rIA and UIA patients than matched controls. ACI increases risk for rIAs.
颅内动脉瘤（IA）患者心血管疾病死亡率过高，但IA 与动脉粥样硬化表现是否共存尚不清楚。本研究旨在探讨未破裂和破裂的颅内动脉瘤与腹主动脉钙化指数（ACI）的相关性。
这是一项回顾性病例对照研究，纳入了 2003 年 1 月至 2018 年 5 月期间因任何原因在三级中心接受头部计算机断层血管造影术（CTA）、磁共振血管造影术（MRA）或数字减影血管造影术（DSA）检查的所有患者（n=24660）。确定患有未破裂或破裂的颅内动脉瘤患者，并纳入有可用腹部 CT 的患者。IA 患者按照性别和年龄与对照组（可用腹部 CT，无颅内动脉瘤）以 1:3 的比例匹配。从腹部 CT 扫描中测量 ACI，并回顾患者记录。
共纳入 1720 名患者（216 例破裂性颅内动脉瘤[rIA]、246 例未破裂性颅内动脉瘤[UIA]和 1258 例对照组）。平均年龄为 62.9±11.9 岁，58.2%为女性。与匹配的对照组相比，ACI（每增加 1 个单位的比值比[OR]为 1.02，95%置信区间[CI]为 1.01-1.03）和 ACI>3（OR 为 5.77，95%CI 为 3.29-10.11）增加了 rIA 的风险。UIA 患者的 ACI 明显较高，但与匹配的对照组相比，UIA 并未增加其发生的几率。rIA 患者的冠心病史较少。8.8%的 rIA 和 13.6%的 UIA 患者的主动脉无钙化（匹配对照组分别为 25.7%和 22.6%，p<0.01）。
与匹配对照组相比，rIA 和 UIA 患者的主动脉钙化更严重。ACI 增加了 rIA 的风险。
