Cerebrovascular Diseases最新文献

{"title":"Carotid Atherosclerosis shows Distinct Patterns of Atheroinflammation and Microcalcification relating to Frailty and Multimorbidity.","authors":"Nicholas R Evans, Shiv Bhakta, Claudia Zeicu, Jason M Tarkin, Mohammed M Chowdhury, James H F Rudd, Elizabeth A Warburton","doi":"10.1159/000546563","DOIUrl":"https://doi.org/10.1159/000546563","url":null,"abstract":"<p><strong>Introduction: </strong>Atherosclerosis involves several important pathophysiological processes, in particular inflammation within the atherosclerotic plaque (atheroinflammation) and microcalcification. Not only do these processes have implications for plaque rupture and consequent thromboembolic events, but the burden of systemic atheroinflammation has also been implicated in downstream organ dysfunction. This study aimed to establish the relationships between different patterns of vascular pathophysiology, frailty, and multimorbidity.</p><p><strong>Methods: </strong>Individuals with ischaemic stroke due to symptomatic carotid atherosclerosis underwent vascular imaging using positron emission tomography with both 18F-fluorodeoxyglucose (FDG, measuring atheroinflammation) and 18F-sodium fluoride (NaF, measuring microcalcification). Pre-morbid frailty was measured using the Clinical Frailty Scale (CFS), and pre-stroke multimorbidity was assessed using the Charlson Co-morbidity Index (CCI).</p><p><strong>Results: </strong>Fifty-two carotids (26 symptomatic culprit atheroma, 26 asymptomatic non-culprit atheroma) were included. On univariable analysis, FDG uptake was associated with CFS (rs=0.68, P<0.001 for the non-culprit artery), which remained significant after adjustment for covariables (beta=1.89, P<0.001). In contrast, NaF uptake was associated with CCI (rs=0.54, P<0.01 for most-diseased segment uptake in the culprit artery), which remained significant on multivariable analysis (beta=0.81, P<0.01). There was no association between FDG uptake and CCI, nor between NaF uptake and CFS.</p><p><strong>Conclusion: </strong>We demonstrate that frailty and multimorbidity show different patterns of vascular pathophysiology. In particular, the association between diffuse atheroinflammation and frailty elucidates the inflammatory basis of frailty that may underlie its disease- and treatment-modifying effects in stroke.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-18"},"PeriodicalIF":2.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Underreporting of Sex-specific Findings in Risk Factors for Unruptured Intracranial Aneurysms.","authors":"Maaike J A van Eldik, Mariam Ali, Stijn Rietkerken, Sanne A E Peters, Hester M den Ruijter, Ynte M Ruigrok","doi":"10.1159/000546774","DOIUrl":"https://doi.org/10.1159/000546774","url":null,"abstract":"<p><strong>Introduction: </strong>Women are overrepresented in the unruptured intracranial aneurysm (UIA) population, with an overall two-third of patients being female. The reasons behind this female preponderance are still unclear. Therefore, we performed a systematic review on clinical risk factors for UIA, with a specific aim of assessing whether these risk factor associations are sex-dependent.</p><p><strong>Methods: </strong>We systematically searched 5 electronic medical databases for all relevant literature up to March 2024. Cohort and case-control studies reporting on the lifestyle factors smoking, alcohol use, hypertension, hypercholesterolemia, physical activity, diabetes, and BMI were included.</p><p><strong>Results: </strong>We found a total of 21 studies, reporting on 347,907 participants and 8,698 UIA cases, that met our inclusion criteria. However, only one out of the 21 studies (<5%) provided its results stratified by sex, making it impossible to perform sex-stratified analyses.</p><p><strong>Conclusion: </strong>Our findings illustrate the scarcity of sex-stratified results in studies on risk factors for UIAs. Since knowledge on potential sex differences in UIA could help understand the female predominance, we highlight a need for more sex-stratified research in this field.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-13"},"PeriodicalIF":2.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoporosis after Stroke: Retracted - Are All Retractions the Same? A Short Discussion on Integrity of Papers and Researchers.","authors":"Stefano Carda, Marco Invernizzi","doi":"10.1159/000546595","DOIUrl":"10.1159/000546595","url":null,"abstract":"","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-2"},"PeriodicalIF":2.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Quality of Stroke Services in Brazil Using the World Stroke Organization Roadmap.","authors":"Aline Palmeira Pires, Kelin Cristine Martin, Thaís L Secchi, Gisele Sampaio Silva, Letícia Costa Rebello, Daniel da Cruz Bezerra, Gabriel R de Freitas, Jamary Oliveira-Filho, Maramelia Miranda-Alves, Gustavo Wruck Kuster, Rodrigo Bazan, Marcos C Lange, João José Freitas de Carvalho, Francisco Jose Arruda Mont'Alverne, José Antonio Fiorot, Viviane F Zetola, Pedro S C Magalhães, Carlos Roberto M Rieder, Luiz Antonio Nasi, Raul Gomes Nogueira, Carla Cabral Moro, Leandro de Assis Barbosa, Wyllians Vendramini Borelli, Octávio Marques Pontes-Neto, Sheila Cristina Ouriques Martins","doi":"10.1159/000546276","DOIUrl":"https://doi.org/10.1159/000546276","url":null,"abstract":"<p><strong>Introduction: </strong>Organizing acute stroke care effectively reduces disability and mortality. Since the Ministry of Health in Brazil established the National Stroke Policy in 2012, stroke care has improved significantly. However, despite the increase in stroke centers, some hospitals have not fully implemented the recommended structure and protocols. This study aims to evaluate the quality of stroke services in Brazil based on the World Stroke Organization (WSO) Roadmap, marking the first step towards the Certification of Stroke Centers in Latin America.</p><p><strong>Method: </strong>From 2020 to 2022, we assessed the structure of stroke centers in Brazil via an online survey based on the WSO Roadmap. When multiple responses came from the same hospital, we checked for consistency and contacted the stroke center coordinator if needed. We then compared these findings to the structure of stroke centers available in 2008, before the national stroke plan began.</p><p><strong>Results: </strong>The number of stroke centers in Brazil increased from 35 in 2008 to 246 in 2022, with 216 centers assessed in this study (102 Essential, 114 Advanced). Advanced centers were mostly private (69%). Of all hospitals, 51% serve public health patients, 75% as Essential centers. The southeast and south region have the highest number of stroke centers (77%). All hospitals provided essential blood tests, CT scans, and thrombolytic therapy, with 97% having pre-hospital emergency services. Neurologists were available 24/7 in 85% of centers (49% on-call, 35% on duty, 16% via telemedicine), and 46% of hospitals had stroke units. Nearly 90% had acute neurosurgical care, and 47% offered endovascular thrombectomy 24/7. Advanced centers implemented 85% of the WSO Roadmap items, and Essential centers 76%. According to WSO/SIECV Certification, 39 centers were prepared for certification, and 18 were certified (6 private - Advanced, 12 public - 4 Advanced, 8 Essential).</p><p><strong>Conclusion: </strong>Brazil has significantly improved its stroke care structure, but disparities and areas for further enhancement remain, particularly in equity, resource access, and best practices implementation. Certification programs could help address these issues and improve outcomes for stroke patients.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-19"},"PeriodicalIF":2.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Coexisting Obesity and Malnutrition and Its Impact on Stroke and Brain Structure: Insights from UK Biobank Study\".","authors":"Huicong Niu","doi":"10.1159/000546570","DOIUrl":"10.1159/000546570","url":null,"abstract":"","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-2"},"PeriodicalIF":2.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Marital/Partner Status and Patient-Reported Outcomes in Stroke Patients: A Systematic Review.","authors":"Cenjing Zhu, Phoebe M Tran, Erica C Leifheit, Erica S Spatz, Rachel P Dreyer, Kate Nyhan, Shi-Yi Wang, Patricia N E Roberson, Larry B Goldstein, Judith H Lichtman","doi":"10.1159/000546413","DOIUrl":"10.1159/000546413","url":null,"abstract":"<p><strong>Introduction: </strong>The extent to which marital/partner status affects patient-reported outcome measures (PROMs) in stroke patients varies among reported studies. We conducted a systematic review and meta-analysis to clarify this relationship.</p><p><strong>Methods: </strong>Five databases (Medline, Web of Science, Scopus, EMBASE, and PsycINFO) were searched from inception to April 15, 2024. Peer-reviewed studies that reported the independent association of marital/partner status with defined PROMs for patients who had a stroke were eligible for inclusion. Results for eligible studies were classified into four predefined outcome domains (health-related quality of life [HRQoL], functional status, symptoms, and personal recovery outcomes). Study quality was appraised using the Newcastle-Ottawa Scale, and data were synthesized by outcome domains.</p><p><strong>Results: </strong>We identified 51 studies (n = 552,943 participants), of which 10 were included in meta-analyses. Being married/partnered was associated with a lower likelihood of poststroke depression (pooled OR, 0.62 [95% CI: 0.43 to 0.89], I2 = 0%), independent of functional outcomes. However, no clear association was found with HRQoL given mixed and insignificant results across physical and mental domains. Qualitative synthesis further suggested that most studies supported better functional and personal recovery outcomes for stroke patients who were married/partnered compared with those who were unpartnered. Data were insufficient to determine whether the association of partner status varied by the sex of the stroke patient.</p><p><strong>Conclusion: </strong>Our findings highlight the importance of the influence of marital/partner status on PROMs among stroke patients for mental health, but not for HRQoL. Future research should aim to harmonize assessments and standardize reporting to enhance further investigation of these associations, determine whether there are differences by sex, and further explore the association between marital/partner status and poststroke functional outcomes.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-21"},"PeriodicalIF":2.2,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Neighbourhood Deprivation with Secondary Prevention Prescribing and All-Cause Mortality among Stroke Patients in Scotland: A Population-Based Study.","authors":"Kadie-Ann Sterling, Melanie Turner, Peter Langhorne, Mary Joan Macleod","doi":"10.1159/000546261","DOIUrl":"10.1159/000546261","url":null,"abstract":"<p><strong>Introduction: </strong>Previous studies have shown that residing in more deprived neighbourhoods is associated with an increased risk for stroke and worse health outcomes. We aimed to investigate the association between neighbourhood deprivation and secondary prevention prescribing and all-cause mortality after a stroke in Scotland.</p><p><strong>Methods: </strong>This retrospective observational study analysed linked data on first-ever stroke patients admitted to hospitals across Scotland between 1 January 2011 and 31 December 2018. Data were obtained from the Scottish Stroke Care Audit (SSCA), hospital admissions dataset, community prescribing and dispensing dataset, and mortality records. Neighbourhood deprivation was assessed using the Scottish Index of Multiple Deprivation (SIMD) quintiles. Study outcomes were 1-year all-cause mortality and secondary prevention prescribing, stratified by stroke type and presence of atrial fibrillation (AF). Findings from Cox regression and logistic regression analyses, with models adjusted for sociodemographic factors, comorbidity burden, stroke severity, and stroke unit admission, are presented.</p><p><strong>Results: </strong>This study included 47,947 stroke patients, of which 11,752 (24.5%) resided in the most deprived areas (quintile 1) and 7,450 (15.6%) resided in the least deprived areas (quintile 5). Compared with patients from the most deprived areas, patients from the least deprived areas were older {78 (interquartile range [IQR] 68-84) vs. 71 (60-81) years}, experienced more intracerebral haemorrhages (12.1% vs. 9.2%), and more AF (26.5% vs. 20.4%). Among ischaemic stroke patients, residing in less deprived areas was associated with reduced hazard of all-cause mortality at 1 year (adjusted hazard ratio [aHR] 0.97; 95% confidence interval [CI], 0.96-0.99), reduced odds of antiplatelet prescription in patients without AF (adjusted odds ratio (aOR, 0.95; 95% CI, 0.92-0.98), and increased odds of being anticoagulated in patients with AF (aOR, 1.15; 95% CI, 1.09-1.20), compared to patients residing in the most deprived areas. No significant differences in all-cause mortality and secondary prevention prescribing by neighbourhood deprivation were found in intracerebral haemorrhage patients.</p><p><strong>Conclusion: </strong>In this retrospective observational study, ischaemic stroke patients residing in the least deprived areas had a lower hazard of 1-year all-cause mortality, lower odds of antiplatelet prescription (in the absence of AF), but higher odds of oral anticoagulant prescription (in the presence of AF), compared to those residing in the most deprived areas. These findings suggest that neighbourhood deprivation is independently associated with all-cause mortality and treatment after stroke, highlighting potential interventions for stroke risk factors and poststroke care, particularly in patients from more deprived areas.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-9"},"PeriodicalIF":2.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stratifying the Utility of Transthoracic Echocardiography for Ischemic Stroke Using a Risk Score.","authors":"Neel D Jani, Haley Basinger, Ann M Jones, Justin A Sattin, Aaron F Struck","doi":"10.1159/000544746","DOIUrl":"10.1159/000544746","url":null,"abstract":"<p><strong>Introduction: </strong>Inpatient transthoracic echocardiography (TTE) is considered to be an important part of secondary prevention in acute ischemic stroke, but can be a barrier to discharge. The goal of the study was to generate a risk score to assess which patients will benefit from a TTE in the inpatient setting.</p><p><strong>Methods: </strong>The training data set consisted of all 874 patients from the UW Health Comprehensive Stroke Registry admitted for acute ischemic stroke/transient ischemic attack (TIA) from 2017 to 2018 that received a TTE. A validation data set of 200 stroke patients was used from the Indiana University Stroke Registry. Using the training data, a modified logistic regression model was developed with simplified coefficients and a limited number of variables. The area under the receiver operator characteristic curve (AUC) was compared between different models and between the training and validation data sets.</p><p><strong>Results: </strong>The training data consisted of 874 patients (52.97% male; median age 64 years). Validation data set consisted of 200 patients (53.5% male; median age, 64 years). For the final model, termed AL2OHA, mean AUC on the training data across five-fold cross validation was 0.78 (95% CI, 0.76-0.80). The model consisted of six variables, and one point was awarded for each: atrial fibrillation, large artery atherosclerosis, large vessel occlusion, obesity, prior antihypertensive medication use, and if the patient's age was 18-39 or ≥70. Risk of positive findings was 6.2% for score of 0, 23.1% for score of 1, 57.4% for score of 2, 85.8% for score of 3, 96.4% for score of 4, and 99.2% for score of 5 or greater. When tested on the external validation data set, AUC was 0.73 and demonstrated to not be significantly different than the AUC for the training data set.</p><p><strong>Conclusions: </strong>The AL2OHA model is a clinical tool which can stratify which patients admitted for acute ischemic stroke/TIA are more likely to benefit from inpatient TTEs.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-7"},"PeriodicalIF":2.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neglect after Isolated Thalamic Stroke: A Systematic Review of the Literature.","authors":"Ariane Dampfhoffer, Dario Cazzoli, Brigitte Charlotte Kaufmann, Thomas Nyffeler","doi":"10.1159/000545473","DOIUrl":"10.1159/000545473","url":null,"abstract":"<p><strong>Introduction: </strong>Recent research has increasingly acknowledged the thalamus's role in the development of neuropsychological deficits, which were previously considered to be primarily related to cortical processes. Among these deficits, neglect is of particular importance in stroke survivors, as it is a predictor of poor functional outcome. This review aimed to clarify the relationship between stroke lateralization and location within the thalamus and the occurrence of neglect.</p><p><strong>Methods: </strong>In the present study, we performed a systematic review according to the PRISMA guidelines. PubMed, Scopus, CINHAL, and Web of Science were searched for articles published from inception to June 30, 2024. All studies presenting cases of isolated vascular thalamic stroke (hemorrhagic, ischemic) and clinical neglect were included. Study quality was assessed using the Joanna Briggs Institute critical appraisal checklist for case reports, case series, and case-control studies. We divided the thalamus into four parts (anterior, lateral, medial, and posterior) based on the four classical vascular territories and performed a qualitative and a simple descriptive statistical analysis using absolute numbers and percentages of the data collected.</p><p><strong>Results: </strong>A total of 23 articles involving 37 patients were included: 31 cases (84%) with right-sided thalamic stroke and 6 cases (16%) with left-sided thalamic stroke. In the hemorrhagic stroke group (21 cases), there was a clear predominance of localization in the posterior (10 cases; 47%) and entire thalamus (9 cases; 43%), with no cases in the anterior part of the thalamus and only one case (5%) each in the medial and lateral parts. In contrast, ischemic cases were predominantly located in the anterior and lateral parts (6 cases each; 37.5%) with only 3 cases (19%) in the medial part and 1 case (6%) in the posterior part.</p><p><strong>Conclusion: </strong>Thalamic neglect appears to occur more frequently in right-sided thalamic strokes than in left-sided thalamic strokes. However, the exact neuroanatomical correlates differed between hemorrhagic and ischemic groups and the underlying mechanisms remain unclear due to the heterogeneity and paucity of data. Rather than drawing definitive conclusions, this work synthesizes existing literature and underscores the need for prospective studies with standardized assessments and advanced neuroimaging.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-18"},"PeriodicalIF":2.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-Depth Carotid Calcification Morphometrics and Their Temporal Changes Are Associated with Cardiovascular Risk Factors in Patients with Recent Ischemic Event: The Plaque At Risk Study.","authors":"Aikaterini Tziotziou, Federica Fontana, Suze-Anne Korteland, Kelly Nies, Paul Nederkoorn, Pim A de Jong, M Eline Kooi, Aad van der Lugt, Anton F W van der Steen, Jolanda J Wentzel, Daniel Bos, Ali C Akyildiz","doi":"10.1159/000546164","DOIUrl":"10.1159/000546164","url":null,"abstract":"<p><strong>Introduction: </strong>Ischemic stroke incidence varies significantly with respect to sex and cardiovascular risk factors (CVRFs), a relationship that it is not well understood. Calcification in carotid atherosclerosis is known to impact plaque stability, potentially linked to ischemic stroke. The objective was to assess the in-depth calcification morphometrics within extracranial carotid atherosclerosis, their temporal changes, and associations with sex and CVRFs.</p><p><strong>Methods: </strong>Carotid arteries (n = 144) with confirmed atherosclerosis and mild-to-moderate stenosis from 72 symptomatic patients (Plaque-At-Risk study) with recent ischemic event due to ischemia in the territory of a carotid artery were imaged using multidetector computed tomography angiography (MDCTA) at baseline and after 2 years. The lumen, vessel wall, and calcifications were segmented semiautomatically, and the carotid geometries were 3D reconstructed. A comprehensive morphometric assessment of carotid calcifications was performed on the baseline and follow-up scans. We investigated distributions of these metrics and their associations with sex and CVRFs using generalized linear mixed models.</p><p><strong>Results: </strong>Our findings suggest that women have larger (4.5 mm2 [95% CI: 3.2-6.2] vs. 3.2 mm2 [95% CI: 2.4-4.2]) calcifications, located closer to the lumen (0.6 mm [95% CI: 0.4-0.8] vs. 0.9 mm [95% CI: 0.7-1.2]) in contrast to men at baseline and follow-up, adjusted for baseline measurements. At the baseline, nonsmokers had larger (5.3 mm2 [95% CI: 3.7-7.5] vs. 3.2 mm2 [95% CI: 2.3-4.4]) and longer (5.7 mm [95% CI: 4.1-7.3] vs. 2.4 mm [95% CI: 1.6-3.6]) calcifications than the current smokers. Diabetic patients had thicker (1.1 mm [95% CI: 0.8-1.3] vs. 0.8 mm [95% CI: 0.7-0.9]) carotid calcifications at baseline.</p><p><strong>Conclusion: </strong>Our in-depth analyses exposed several geometric features of carotid calcifications associated with sex and CVRFs and provided further insight into the pathophysiology of carotid atherosclerosis.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}