Department of Neurology, Shanghai Fifth People's Hospital (D.H., X.Y., Y.W., S.H., D.W.), Fudan University, Shanghai, China.
Department of Neurology, Huashan Hospital (Y.T.), Fudan University, Shanghai, China.
Arterioscler Thromb Vasc Biol. 2022 Aug;42(8):1094-1101. doi: 10.1161/ATVBAHA.122.317670. Epub 2022 Jun 2.
Arterial calcification in the aortic arch, carotid bifurcation, or siphon on computed tomography was associated with cardiovascular disease. The association between arterial calcification prevalence and progression of branch atheromatous disease (BAD) in intracranial artery atherosclerosis was little investigated.
This study included 310 patients with ischemic stroke from one stroke center. Patients were divided into BAD (110) and non-BAD groups (200). Baseline characteristics, lipids, and arterial calcification were measured. The primary outcome was the prevalence of arterial calcification in BAD progression, and the secondary outcome was the prevalence of calcification in arterial stenosis. The association or correlation among calcification prevalence, lipid markers, and BAD progression was analyzed using logistic regression, receiver operating characteristic curve, and linear regression.
Our study found that carotid siphon calcification on computed angiography was more prevalent (=0.01) in patients with BAD and also more prevalent (<0.001) in intracranial artery stenosis, and its computed tomography values could independently predict the symptomatic progression (=0.01). Furthermore, a strong linear correlation between oxidized lipid and calcification density was found (beta=-0.73, =0.0048) in patients with BAD, a subtype (B-type) of intracranial arterial atherosclerotic disease.
We found that carotid siphon calcification was associated with BAD and its computed tomography values could predict the symptomatic progression in patients with intracranial arterial atherosclerotic disease and BAD, indicating the important role of carotid calcification in B-type intracranial arterial atherosclerotic disease.
URL: http://www.chictr.org.cn; Unique identifier: ChiCTR1800018315.
计算机断层扫描（CT）显示的主动脉弓、颈动脉分叉或虹吸处的动脉钙化与心血管疾病相关。然而，颅内动脉粥样硬化性病变分支动脉粥样硬化（BAD）的进展与动脉钙化的相关性研究较少。
本研究纳入了来自一家卒中中心的 310 例缺血性卒中患者。根据 BAD 有无将患者分为 BAD 组（110 例）和非 BAD 组（200 例）。测量基线特征、血脂和动脉钙化情况。主要结局为 BAD 进展时动脉钙化的发生率，次要结局为动脉狭窄时钙化的发生率。采用逻辑回归、受试者工作特征曲线和线性回归分析钙化发生率、血脂标志物与 BAD 进展之间的相关性或关联。
本研究发现，BAD 患者的 CT 血管造影显示颈动脉虹吸钙化更为常见（=0.01），且颅内动脉狭窄患者的颈动脉虹吸钙化更为常见（<0.001），其 CT 值可独立预测症状性进展（=0.01）。此外，还发现 BAD 患者存在氧化脂质与钙化密度之间存在很强的线性相关性（β=-0.73，=0.0048），BAD 是颅内动脉粥样硬化性疾病的一种亚型（B 型）。
我们发现颈动脉虹吸钙化与 BAD 相关，其 CT 值可预测颅内动脉粥样硬化性疾病和 BAD 患者的症状性进展，表明颈动脉钙化在 B 型颅内动脉粥样硬化性疾病中具有重要作用。
