Abstract Details

Title Association Between Coronary Artery Atherosclerosis and Intracranial Artery Atherosclerosis in a Clinicopathological Study

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P5 - Poster Session 5 (11:45 AM-12:45 PM)

Poster/Presentation
Number 4-016

Objective To investigate the association of size and composition of atheroma plaques in coronary arteries with atherosclerosis obstruction in intracranial cerebral arteries in a large autopsy study.

Background There is limited understanding about how atherosclerosis is associated across different arterial sites, limiting integrated cardiovascular and cerebrovascular risk assessment.

Design/Methods

Coronary plaques were microscopically evaluated regarding obstruction and composition, and intracranial arteries were analyzed macroscopically. Plaque components and obstruction were manually delineated using the Atherosclerotic Plaque Analyzer. Analyses employed ordinal and multinomial logistic regression, using robust errors to account for clustered arterial segments within each individual, adjusted for demographic, clinical, and lifestyle risk factors.

Results The sample (n=405) was predominantly composed of women (52.3%) and the mean age was 71±12 years. Most prevalent risk factors were hypertension (64.7%) and physical inactivity (53.3%). In coronary arteries, the mean obstruction was 54.5±16.7% with intima-media thickness of 516.9±154.9 μm. Plaques showed lipid predominance (27.9±17.3%), low smooth muscle cell presence, and instability markers were present in 22.6% of segments. In the Circle of Willis, 61.0% had mild obstruction and 6.7% severe obstruction. Adjusted models showed that larger coronary obstructions(OR=1.20; 95%CI: 1.10-1.31; p<0.001), greater intima-media thickness (OR=1.08; 95%CI: 1.01-1.15; p=0.016), and plaque instability (OR=1.56; 95%CI: 1.17-2.10; p=0.003) were associated with higher odds for obstruction in cerebral arteries. Lipid deposits, fibrosis, fibrous cap, intraplaque hemorrhage, and thrombus were associated with severe cerebral artery obstruction, while an increased area of smooth muscle cells was associated with lower odds of cerebral artery obstruction, probably due to its association with lower coronary artery obstruction.

Conclusions

Our findings reinforce atherosclerosis as a systemic disease, as greater coronary obstruction and worse plaque composition profiles were associated with more severe cerebral atherosclerosis.

Authors/Disclosures
Lívia C. Barbosa Almeida, Medical Student (MS) PRESENTER	Miss Barbosa Almeida has received research support from CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico).
Claudia K. Suemoto, MD, PhD	The institution of Dr. Suemoto has received research support from Alzheimer's Association.
Naomi V. Ferreira, PhD	Dr. Ferreira has nothing to disclose.

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