Atherosclerosis Burden of Brain‐ and Heart‐Supplying Arteries and the Relationship With Vascular Risk in Patients With Ischemic Stroke

Kong, Qi; Ma, Xin; Li, Luguang; Wang, Chen; Du, Xiangying; Wan, Yungao

doi:10.1161/jaha.123.029505

Cited by 6 publications

(2 citation statements)

References 24 publications

(36 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Using the dual-source 192-slice CT scanner (Somatom Force, Siemens Healthcare, Erlangen, Germany), all combined coronary and cervicocephalic CTAs were conducted out as previously reported ( 19 ). The CTA scans were conducted from the base of the heart to the head cauda-cranially, using an automated kVp and mA (CARE kV and CARE Dose4D, Siemens) with a pitch of 3.2 and a rotation time of 250 ms.…”

Section: Methodsmentioning

confidence: 99%

Predicting asymptomatic coronary artery disease in first-ever acute ischemic stroke patients: a cross-sectional study

Wang,

Zheng,

Bao

et al. 2024

Quant Imaging Med Surg

View full text Add to dashboard Cite

Background It is frequently observed that patients with first-ever acute ischemic stroke (AIS) have a common occurrence of asymptomatic coronary artery disease (CAD). This condition is associated with a poor prognosis. Early detection and recognition of asymptomatic CAD in first-ever AIS patients may optimize the clinical management and ultimately lead to improved outcomes. The aim of this study was to investigate the role of aortic arch plaque (AAP) detected through combined computed tomography angiography (CTA) as an early predictor of asymptomatic CAD in patients with first-ever AIS without prior diagnosis of CAD. Methods A cross-sectional study was conducted at Xuanwu Hospital, Capital Medical University from January 2019 to December 2021, involving patients with first-ever AIS caused by large arterial atherosclerosis. Patients with a history of recognized cardiovascular disease, nonatherosclerotic arterial stenosis, atrial fibrillation related to cardioembolism, and complete carotid occlusions were excluded. The study utilized a combined coronary and cervicocephalic CTA to evaluate atherosclerosis in the cervicocephalic, aortic, and coronary arteries simultaneously. First-ever AIS patients without prior diagnosis of CAD were divided into 2 groups: 1 with asymptomatic CAD detected through CTA and the other without. Multivariate logistic regression was used to identify independent risk factors associated with the presence of asymptomatic CAD, including aortic arch, cervical and intracranial atherosclerotic characteristics (e.g., vascular stenosis, plaque thickness, extent, and complexity). Results Among 182 AIS patients, 84 (46.2%) had asymptomatic CAD. Increased aortic arch plaque (AAP) thickness per millimeter [adjusted odds ratio (aOR): 1.26; 95% confidence interval (CI): 1.08–1.47], presence of severe AAP (aOR: 4.24; 95% CI: 1.59–12.03), mixed AAP (aOR: 2.65; 95% CI: 1.09–6.62), and ulcerative AAP (aOR: 11.76; 95% CI: 2.05–222.84) raised the risk of asymptomatic CAD in stroke patients, independent of other factors. The combination of ulcerative AAP, diabetes mellitus, and smoking could predict asymptomatic CAD with an area under the receiver operating characteristic curve (AUC) of 0.71 (95% CI: 0.64–0.79; P<0.001). Ulcerative AAP was found to be more valuable than cervicocephalic atherosclerotic characteristics for predicting asymptomatic CAD in first-ever AIS patients. Conclusions The presence of ulcerative AAP was associated with asymptomatic CAD in first-ever AIS patients. As an early systemic atherosclerosis feature, ulcerative AAP is probably a more valuable indicator than cervicocephalic atherosclerotic characteristics for predicting asymptomatic CAD in AIS patients.

show abstract

Section: Methodsmentioning

confidence: 99%

Predicting asymptomatic coronary artery disease in first-ever acute ischemic stroke patients: a cross-sectional study

Wang,

Zheng,

Bao

et al. 2024

Quant Imaging Med Surg

View full text Add to dashboard Cite

show abstract

“…All patients underwent simultaneous CTAs of the coronary and craniocervical arteries with a 192-slice dual-source computed tomography (Somatom Force; Siemens, Munich, Germany), as previously reported [18]. Two experienced radiologists who were blinded to the clinical information analyzed all the scanned images independently and provided a consensus interpretation of each conclusion.…”

Section: Assessment Of Atherosclerosis Conditions In Baroreceptor-res...mentioning

confidence: 99%

Associations between Total Atherosclerosis Burden of Baroreceptor-Resident Arteries and ECG Abnormalities after Acute Ischemic Stroke

Fu,

Ma,

Zhao

et al. 2024

Brain Sciences

Self Cite

View full text Add to dashboard Cite

Electrocardiogram (ECG) abnormalities are the most common cardiac complications after acute ischemic stroke (AIS) and predict poor outcomes. The arterial baroreflex is an essential determinant of cardiovascular autonomic regulation, with receptors mainly residing in carotid sinuses and aortic arch. The atherosclerosis of these baroreceptor-resident arteries (BRA) is very common in AIS patients and might impair baroreflex function. However, the associations between the atherosclerosis of BRA and ECG abnormalities after AIS are still unknown. In total, 228 AIS patients within 7 days after onset without a pre-existing heart disease were prospectively recruited. With computed tomography angiography, atherosclerosis conditions in 10 segments of the carotid sinuses and aortic arch were scored and summed as the Total Atherosclerosis Burden of BRA (TAB-BRA), and asymptomatic coronary artery stenosis (ACAS) ≥50% was simultaneously assessed. We performed 12-lead ECG to dynamically detect abnormal repolarization, and 24 h Holter ECG to monitor arrhythmias and heart rate variability (HRV) parameters, which are reliable indicators to assess cardiac autonomic function. We found that TAB-BRA was positively associated with abnormal repolarization (OR 1.09; CI% 1.03–1.16; p = 0.003) and serious cardiac arrhythmias (OR 1.08; CI% 1.01–1.15; p = 0.021). In addition, TAB-BRA was an important predictor of abnormal repolarization, persisting over 3 days (OR 1.17; CI% 1.05–1.30; p = 0.003). However, ACAS ≥ 50% did not relate to these ECG abnormalities. TAB-BRA was negatively correlated with parasympathetic-related HRV parameters. Our results indicated that AIS patients with a high TAB-BRA are more likely to have ECG abnormalities and delayed normalization, which may relate to the decreased cardiac parasympathetic activity, but not the accompanied ACAS ≥ 50%.

show abstract

Correlation between blood inflammatory indices and carotid intima-media thickness in the middle-aged and elderly adults

Zhang,

Cui,

Zhang

et al. 2024

Journal of Stroke and Cerebrovascular Diseases

View full text Add to dashboard Cite

Atherosclerosis Burden of Brain‐ and Heart‐Supplying Arteries and the Relationship With Vascular Risk in Patients With Ischemic Stroke

Cited by 6 publications

References 24 publications

Predicting asymptomatic coronary artery disease in first-ever acute ischemic stroke patients: a cross-sectional study

Predicting asymptomatic coronary artery disease in first-ever acute ischemic stroke patients: a cross-sectional study

Associations between Total Atherosclerosis Burden of Baroreceptor-Resident Arteries and ECG Abnormalities after Acute Ischemic Stroke

Correlation between blood inflammatory indices and carotid intima-media thickness in the middle-aged and elderly adults

Contact Info

Product

Resources

About