Abstract Details

Title Cerebral Small Vessel Disease and Cervicocerebral Large Artery Stenosis Independently Increase Ischemic Stroke Risk in the General Population

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-014

Objective We performed a prospective study in a large community based elderly population, to assess the predictive value of cerebral small vessel disease (CSVD) and cervicocerebral artery stenosis for future ischemic stroke.

Background CSVD and atherosclerotic stenosis of cervicocerebral arteries are associated with an increased risk of subsequent stroke in general population, but little is known about their individual contribution to stroke onset.

Design/Methods In the population-based prospective Shunyi Study, CSVD markers, including lacunes, cerebral microbleeds (CMB), white matter hyperintensity (WMH) and enlarged perivascular space were assessed at baseline on brain MRI of 1211 stroke free participants (mean 55.6 years). Total SVD score was used to capture the overall CSVD burden. Cervicocerebral artery stenosis was assessed on brain MRA and carotid ultrasound. Participants were followed for stroke for on average 2.3 years. We estimated the risk of ischemic stroke in relation to presence of CSVD markers, total SVD score and cervicocerebral stenosis with Cox proportion hazards regression analysis.

Results

Twenty-five participants (2.1%) experienced at least 1 stroke (21 ischemic and 4 hemorrhagic) during follow up. Cervicocerebral stenosis, lacunes, confluent or beginning confluent WMHs and CMBs were associated with increased risk of ischemic stroke. After adjustment of cardiovascular risk factors, cervicocerebral stenosis and CSVD markers simultaneously, the association remained for deep or infrantentorial (D/I) CMBs (HR 3.38; 95%CI 1.07-10.64) and cervicocerebral stenosis (HR 4.91; 95%CI 1.74-13.84). In comparison with those scored 0, participants with SVD score 2-4 points increased the risk of ischemic stroke>9-fold (HR 9.79; 95%CI 2.45-39.13), independent of cardiovascular risk factors and cervicocerebral stenosis.

Conclusions In a large population based Chinese sample, CSVD and cervicocerebral large artery stenosis independently increased the risk of ischemic stroke, with similar predictive value. Our results highlight the notion th burden of CSVD should be considered when making decisions about stroke prevention.

Authors/Disclosures
Fei Han PRESENTER	Fei Han has nothing to disclose.
Fei-Fei Zhai	Fei-Fei Zhai has nothing to disclose.
	No disclosure on file
Ding-Ding Zhang	Ding-Ding Zhang has nothing to disclose.
Jiang-Tao Zhang (Peking Union Medical College)	No disclosure on file
Lixin Zhou	Lixin Zhou has nothing to disclose.
Jun Ni	Jun Ni has nothing to disclose.
Ming Yao	Ming Yao has nothing to disclose.
Liying Cui, PhD (Peking Union Medical College Hospital)	No disclosure on file
Ming-Li Li	No disclosure on file
Zheng-Yu Jin	No disclosure on file
Yi-Cheng Zhu, MD, PhD (Peking Union Medical College Hospital)	Dr. Zhu has nothing to disclose.

��ɫ��

��ɫ��