Atherosclerosis in patients with cervical artery dissection.

IF 5.8 3区医学 Q1 CLINICAL NEUROLOGY

European Stroke Journal Pub Date : 2024-09-04 DOI:10.1177/23969873241274547

Eveline Brunner, Josefin E Kaufmann, Sandro Fischer, Henrik Gensicke, Annaelle Zietz, Alexandros A Polymeris, Valerian L Altersberger, Philippe A Lyrer, Christopher Traenka, Stefan T Engelter

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引用次数: 0

Abstract

Introduction: Cervical artery dissection (CeAD) is considered a non-atherosclerotic arteriopathy, but atherosclerosis of the cervical arteries may co-exist. We explored the frequency and clinical importance of co-existent atherosclerosis in patients with CeAD.

Patients and methods: Single-center exploratory study from the Stroke Center Basel, Switzerland. We re-reviewed duplex ultrasound images at (i) baseline and (ii) last follow-up visit for the presence versus absence of the following atherosclerotic manifestations in the carotid arteries: (i) abnormal carotid intima-media thickness, (ii) plaques, and (iii) atherosclerotic stenosis. We investigated whether CeAD patients with versus without co-existing atherosclerosis differ regarding (a) recurrence of CeAD and (b) occurrence of vascular events (myocardial infarction, peripheral artery disease, or ischemic stroke) using logistic regression with adjustment for age and follow-up time.

Results: Among 294 CeAD patients (median age 46 [IQR 37-53], 41.8% women), 35 (12%) had any atherosclerotic signs at baseline. Among 196 patients with available follow-up, another 21/196 (11%) patients developed atherosclerosis during a median follow-up of 55.7 months. Patients with atherosclerosis had decreased odds of recurrent CeADs when compared to patients without atherosclerosis (OR 0.03, 95% CI = 0.00-0.30). During follow-up, 6 (15%) vascular events occurred among 40 CeAD patients with atherosclerosis and 13 (8.5%) among 153 patients without atherosclerosis (OR 1.38, 95% CI = 0.39-4.55, data for 3 patients were missing).

Discussion and conclusion: Signs of atherosclerosis in the carotid artery were detectable in 12% of CeAD patient at baseline. Additionally, 11% of CeAD patients developed new signs of atherosclerosis within the following 5 years. The presence of atherosclerosis may suggest a lower risk for recurrent CeAD. Whether it might indicate an increased risk for late clinical vascular events deserves further studies.

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颈动脉夹层患者的动脉粥样硬化。

简介颈动脉夹层（CeAD）被认为是一种非动脉粥样硬化性动脉病变，但颈动脉可能同时存在动脉粥样硬化。我们探讨了CeAD患者并存动脉粥样硬化的频率和临床重要性：瑞士巴塞尔卒中中心的单中心探索性研究。我们重新审查了(i)基线和(ii)最后一次随访时的双工超声图像，以确定颈动脉是否存在以下动脉粥样硬化表现：(i)颈动脉内膜-中层厚度异常、(ii)斑块和(iii)动脉粥样硬化性狭窄。我们通过调整年龄和随访时间的逻辑回归方法，研究了合并动脉粥样硬化的 CeAD 患者与未合并动脉粥样硬化的 CeAD 患者在以下方面是否存在差异：(a) CeAD 复发率；(b) 血管事件（心肌梗死、外周动脉疾病或缺血性中风）的发生率：294 名 CeAD 患者（中位年龄 46 [IQR：37-53]，41.8% 为女性）中，35 人（12%）在基线时有任何动脉粥样硬化迹象。在有随访记录的196名患者中，有21/196（11%）名患者在中位随访55.7个月期间出现了动脉粥样硬化。与无动脉粥样硬化的患者相比，有动脉粥样硬化的患者复发 CeAD 的几率较低（OR 0.03，95% CI = 0.00-0.30）。在随访期间，40 名有动脉粥样硬化的 CeAD 患者中发生了 6 起（15%）血管事件，153 名无动脉粥样硬化的患者中发生了 13 起（8.5%）血管事件（OR 1.38，95% CI = 0.39-4.55，3 名患者数据缺失）：讨论与结论：12%的CeAD患者在基线时可检测到颈动脉粥样硬化的迹象。此外，11%的CeAD患者在随后的5年内出现了新的动脉粥样硬化迹象。动脉粥样硬化的存在可能意味着复发 CeAD 的风险较低。至于动脉粥样硬化是否会增加晚期临床血管事件的风险，还有待进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Stroke Journal Multiple-

CiteScore

7.50

自引率

6.60%

发文量

102

期刊介绍： Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.