دورية أكاديمية
أعرض في EDS

Small vessel disease is associated with later onset of major adverse cardiovascular events after acute cervicocerebral artery dissection.

التفاصيل البيبلوغرافية
العنوان: Small vessel disease is associated with later onset of major adverse cardiovascular events after acute cervicocerebral artery dissection.
المؤلفون: Muppa J; Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA. Electronic address: jayachandra.muppa@umassmed.edu., Gunduz ME; Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA., Aleyadeh R; Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA., Yaghi S; Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA., Shu L; Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA., Henninger N; Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA; Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, USA.
المصدر: Journal of the neurological sciences [J Neurol Sci] 2023 Oct 15; Vol. 453, pp. 120786. Date of Electronic Publication: 2023 Sep 07.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 0375403 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-5883 (Electronic) Linking ISSN: 0022510X NLM ISO Abbreviation: J Neurol Sci Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Amsterdam : Elsevier, <19 ->
مستخلص: Background: Cerebral small vessel disease (CSVD) is common among the elderly and has been associated with an increased risk of major adverse cardiac events (MACE) and increased risk of long-term disability. Little is known whether CSVD affects outcomes after cervicocerebral artery dissection (CAD), which predominantly affects younger patients. Specifically, there is a paucity as to whether CSVD increases the risk of MACE after CAD and whether this risk is different for early versus late events.
Methods: We retrospectively analyzed 140 consecutive patients with acute CAD. We determined CSVD on MRI using the STRIVE criteria and calculated the CSVD sum score based on the individual CSVD components. For statistical analysis the CSVD burden was dichotomized to mild (score 0-1) versus severe (score 2-4). The primary outcome of interest was the 6-month MACE risk. Secondary outcomes of interest were early versus late MACE, stroke at presentation, and good 90-day outcome (modified Rankin Scale score 0-2).
Results: There was no difference in overall MACE between subjects when stratified by CSVD burden (10.1% versus 9.8%, Log-rank P = 0.953). We found that patients with severe CSVD had significantly more late MACE as compared to mild CSVD (9.8% versus 1.1%, P = 0.024). There was no significant difference in the prevalence of stroke at the time of CAD diagnosis (50.6% versus 47.1%, P = 0.690) and the 90-day disability-free survival in subjects with mild versus severe CSVD (93.7% versus 91.7%, P = 0.729).
Conclusion: Severe CSVD burden was associated with a significantly greater risk of late MACE. CSVD assessment in CAD patients may aid risk stratification and treatment optimization.
Competing Interests: Declaration of Competing Interest All authors report no disclosures.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
فهرسة مساهمة: Keywords: Disability; Modified Rankin Scale; Small vessel disease; Stroke; Survival analysis
تواريخ الأحداث: Date Created: 20230913 Latest Revision: 20231016
رمز التحديث: 20231215
DOI: 10.1016/j.jns.2023.120786
PMID: 37703707
قاعدة البيانات: MEDLINE
الوصف
تدمد:1878-5883
DOI:10.1016/j.jns.2023.120786