Carotid Atherosclerotic Calcification Characteristics Relate to Post-stroke Cognitive Impairment.
Carotid Atherosclerotic Calcification Characteristics Relate to Post-stroke Cognitive Impairment.
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颈动脉粥样硬化钙化特征与中风后认知障碍有关
DOI：
10.3389/fnagi.2021.682908
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发表时间：
2021
影响因子：
4.8
通讯作者：
Cui M
中科院分区：
文献类型：
--
作者：
Wang Y;Li C;Ding M;Lin L;Li P;Wang Y;Dong Q;Yang Y;Cui M
背景：与脑小血管疾病（CSVD）一样，大血管动脉粥样硬化被认为是血管性认知障碍进展中同样重要的危险因素。本文旨在调查颈动脉粥样硬化钙化是否与中风后认知障碍（PSCI）风险增加相关。方法：共有128例缺血性脑卒中患者（平均年龄：62.1±12.2岁，37名女性）接受了脑/颈部计算机断层扫描血管造影检查。通过计算机断层扫描血管造影分析颈动脉钙化的存在和特征（大小、数量和位置）。使用 Fazekas 量表评估白质高信号 (WMH)。 PSCI 的诊断基于中风后 6-12 个月实施的一系列神经心理学评估。结果：128 名患者中，26 人出现中风后痴呆，96 人出现颈动脉钙化。 Logistic 回归发现颈动脉钙化（比值比 [OR] = 7.15，95% 置信区间 [CI]：1.07–47.69）和颈动脉狭窄（OR = 6.42，95% CI：1.03–40.15）均显着增加中风后痴呆的风险。此外，PSCI 中多发、厚/混合和表面钙化呈增加趋势（Ptrend 分别 = 0.004、0.016、0.045）。包括颈动脉钙化（曲线下面积 = 0.67）、WMH（曲线下面积 = 0.67）和其他协变量在内的中风后痴呆的预测模型得出的曲线下面积（AUC）为 0.90（95% CI：0.82-0.99）。结论：我们的研究结果表明，颈动脉钙化的数量和位置是 PSCI 的独立指标。大血管动脉粥样硬化在 PSCI 中的重要作用应在未来的研究中予以关注。
Background: Together with cerebral small vessel disease (CSVD), large vessel atherosclerosis is considered to be an equally important risk factor in the progression of vascular cognitive impairment. This article aims to investigate whether carotid atherosclerotic calcification is associated with the increased risk of post-stroke cognitive impairment (PSCI). Methods: A total of 128 patients (mean age: 62.1 ± 12.2 years, 37 women) suffering from ischemic stroke underwent brain/neck computer tomography angiography examination. The presence and characteristic of carotid calcification (size, number and location) were analyzed on computer tomography angiography. White matter hyperintensity (WMH) was assessed using Fazekas scales. PSCI was diagnosed based on a battery of neuropsychological assessments implemented 6−12 months after stroke. Results: Among 128 patients, 26 developed post-stroke dementia and 96 had carotid calcification. Logistic regression found carotid calcification (odds ratio [OR] = 7.15, 95% confidence interval [CI]: 1.07–47.69) and carotid artery stenosis (OR = 6.42, 95% CI: 1.03–40.15) both significantly increased the risk for post-stroke dementia. Moreover, multiple, thick/mixed, and surface calcifications exhibited an increasing trend in PSCI (Ptrend = 0.004, 0.016, 0.045, respectively). The prediction model for post-stroke dementia including carotid calcification (area under curve = 0.67), WMH (area under curve = 0.67) and other covariates yielded an area under curve (AUC) of 0.90 (95% CI: 0.82–0.99). Conclusion: Our findings demonstrated that the quantity and location of carotid calcifications were independent indicators for PSCI. The significant role of large vessel atherosclerosis in PSCI should be concerned in future study.
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作者：
Gottesman, Rebecca F.;Hillis, Argye E.
通讯作者：
Hillis, Argye E.
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