Coronary heart disease in moyamoya disease: are they concomitant or coincidence?

Area of Science:

• Cardiology
• Neurology
• Vascular Medicine

Background:

• Moyamoya disease (MMD) is a rare cerebrovascular disorder characterized by progressive stenosis of the internal carotid arteries.
• Coronary heart disease (CHD) is a significant cause of morbidity and mortality worldwide.
• The relationship between MMD and CHD is not well-established.

Purpose of the Study:

• To determine the prevalence and characteristics of symptomatic coronary heart disease (CHD) in patients diagnosed with moyamoya disease (MMD).
• To identify risk factors associated with CHD in the MMD population.
• To explore the potential systemic nature of CHD in MMD.

Main Methods:

• Retrospective study of 456 patients examined for MMD between 1995 and 2012.
• Review of medical history and coronary imaging, including conventional coronary angiography and coronary computed tomography angiogram (CTA).
• Statistical analysis including uni- and multivariate analyses to identify risk factors.

Main Results:

• Symptomatic CHD was identified in 21 out of 456 MMD patients (4.6%).
• Patients with CHD had a median age of 44 years and a low median Framingham score (<1%).
• Older age was significantly associated with CHD in MMD patients (OR, 1.053; P = 0.021).

Conclusions:

• Symptomatic CHD occurs in a notable proportion of MMD patients.
• Older age is a key risk factor for developing CHD in individuals with MMD.
• CHD may represent a systemic manifestation associated with moyamoya disease, warranting further investigation.