Abstract Details

Title Clinical Characteristics of Cerebral Amyloid Angiopathy and Risk Factors of Cerebral Amyloid Angiopathy Related Intracerebral Hemorrhage

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S36 - Cerebrovascular Disease and Interventional Neurology: Basic and Translational Science (2:36 PM-2:48 PM)

Poster/Presentation
Number 009

Objective

This article aims to describe the characteristics of different subtypes of CAA and identify the risk factors of intracerebral hemorrhage (ICH) in CAA patients.

Background There is limited understanding of the difference between hemorrhagic and non-hemorrhagic type of cerebral amyloid angiopathy (CAA), but there are significant differences in their clinical course and impact on prognosis.

Design/Methods Patients consecutively enrolled in the national multicenter prospective "Cerebral Small Vessel Disease Cohort Study" from March 2017 to May 2022 who met the Boston diagnostic criteria for CAA or CAA-related inflammation were selected. Demographic data, apolipoprotein E(APOE) genotype, cranial magnetic resonance imaging including gradient echo sequence and laboratory data were collected. Patients with a past/present medical history of non-traumatic symptomatic ICH were classified as hemorrhagic type after exclusion of other etiologies.

Results A total of 219 CAA patients were included, with an average age of 67.12±9.93. 62.6% were male, and 26.0% were hemorrhagic CAA patients. Univariate analysis showed that there were differences between CAA hemorrhagic and non-hemorrhagic groups in terms of carrying APOE ε 2 allele, carrying APOE ε4 allele, number of lobar microbleeds, Fazekas grade, gait disorder, mood change, bulbar paralysis, onset, history of hypertension, blood pressure control, antiplatelet therapy and modified Rankin scale score between CAA hemorrhagic group and non-hemorrhagic group (P < 0.1). Logistic regression analysis showed that carrying APOE ε 2 allele and the number of lobar microbleeds is associated with hemorrhagic CAA (P < 0.05).

Conclusions It is meaningful and necessary to classify hemorrhagic or non-hemorrhagic CAA. When patients have comorbidities and require antithrombotic therapy, it is particularly important to identify patients with high bleeding risk and reduce antithrombotic intensity. CAA-ICH patients are more often carrying APOE ε2 allele and a relatively small number of microbleeds, thus antithrombotic therapy should be carefully selected for CAA patients with such characteristics.

Authors/Disclosures
Juanjuan Wu, Other (Peking Union Medical College Hospital) PRESENTER	Dr. Wu has nothing to disclose.
Zi-Yue Liu	Zi-Yue Liu has nothing to disclose.
Ming Yao	Ming Yao has nothing to disclose.
Yi-Cheng Zhu, MD, PhD (Peking Union Medical College Hospital)	Dr. Zhu has nothing to disclose.
	No disclosure on file
Jun Ni	Jun Ni has nothing to disclose.

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