TY - JOUR
T1 - Prevalence of Intracranial Atherosclerotic Stenosis Using High-Resolution Magnetic Resonance Angiography in the General Population
T2 - The Atherosclerosis Risk in Communities Study
AU - Suri, Muhammad Fareed K
AU - Qiao, Ye
AU - Ma, Xiaoye
AU - Guallar, Eliseo
AU - Zhou, Jincheng
AU - Zhang, Yiyi
AU - Liu, Li
AU - Chu, Haitao
AU - Qureshi, Adnan I.
AU - Alonso, Alvaro
AU - Folsom, Aaron R.
AU - Wasserman, Bruce A.
N1 - Publisher Copyright:
© 2016 American Heart Association, Inc.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Background and Purpose - Intracranial atherosclerotic stenosis (ICAS) is a common cause of stroke, but little is known about its epidemiology. We studied the prevalence of ICAS and its association with vascular risk factors using high-resolution magnetic resonance angiography in a US cardiovascular cohort. Methods - The Atherosclerosis Risk in Communities (ARIC) study recruited participants from 4 US communities from 1987 to 1989. Using stratified sampling, we selected 1980 participants from visit 5 (2011-2013) for high-resolution 3T-magnetic resonance angiography. All images were analyzed in a centralized laboratory, and ICAS was graded as: no stenosis, <50% stenosis, 50% to 69% stenosis, 70% to 99% stenosis, and complete occlusion. We calculated per-vessel and per-person prevalence of ICAS (weighted for n=6538 visit 5 participants) and also estimated the US prevalence. We used multivariable logistic regression to identify variables independently associated with ICAS. Results - Subjects who had an adequate magnetic resonance angiography (n=1765) were aged 67 to 90 years, 41% were men, 70% were white, and 29% were black. ICAS was prevalent in 31% of participants and 9% had ICAS ≥50%. Estimated US prevalence of ICAS ≥50% for 65 to 90 years old was 8% for whites and 12% for blacks. Older age, black race, higher systolic blood pressure, and higher low-density lipoprotein cholesterol levels were associated with increased odds of ICAS, whereas higher levels of high-density lipoprotein cholesterol and use of cholesterol-lowering medications were associated with decreased odds of ICAS. Body mass index and smoking were not associated with ICAS. Conclusions - The prevalence of ICAS in older adults is high, and it could be a target for primary prevention of stroke and dementia in this population.
AB - Background and Purpose - Intracranial atherosclerotic stenosis (ICAS) is a common cause of stroke, but little is known about its epidemiology. We studied the prevalence of ICAS and its association with vascular risk factors using high-resolution magnetic resonance angiography in a US cardiovascular cohort. Methods - The Atherosclerosis Risk in Communities (ARIC) study recruited participants from 4 US communities from 1987 to 1989. Using stratified sampling, we selected 1980 participants from visit 5 (2011-2013) for high-resolution 3T-magnetic resonance angiography. All images were analyzed in a centralized laboratory, and ICAS was graded as: no stenosis, <50% stenosis, 50% to 69% stenosis, 70% to 99% stenosis, and complete occlusion. We calculated per-vessel and per-person prevalence of ICAS (weighted for n=6538 visit 5 participants) and also estimated the US prevalence. We used multivariable logistic regression to identify variables independently associated with ICAS. Results - Subjects who had an adequate magnetic resonance angiography (n=1765) were aged 67 to 90 years, 41% were men, 70% were white, and 29% were black. ICAS was prevalent in 31% of participants and 9% had ICAS ≥50%. Estimated US prevalence of ICAS ≥50% for 65 to 90 years old was 8% for whites and 12% for blacks. Older age, black race, higher systolic blood pressure, and higher low-density lipoprotein cholesterol levels were associated with increased odds of ICAS, whereas higher levels of high-density lipoprotein cholesterol and use of cholesterol-lowering medications were associated with decreased odds of ICAS. Body mass index and smoking were not associated with ICAS. Conclusions - The prevalence of ICAS in older adults is high, and it could be a target for primary prevention of stroke and dementia in this population.
KW - intracranial atherosclerosis stenosis
KW - intracranial stenosis
KW - magnetic resonance angiography
KW - prevalence
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U2 - 10.1161/STROKEAHA.115.011292
DO - 10.1161/STROKEAHA.115.011292
M3 - Article
C2 - 27056984
AN - SCOPUS:84964047339
SN - 0039-2499
VL - 47
SP - 1187
EP - 1193
JO - Stroke
JF - Stroke
IS - 5
ER -