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Association between large artery atherosclerosis and cerebral microbleeds: a systematic review and meta-analysis

Lingling Ding1, Yuehui Hong1, Bin Peng1

  • 1Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, China.

Stroke and Vascular Neurology
|September 30, 2017
PubMed

Insights

Biomarkers of large artery atherosclerosis, such as arterial stenosis and carotid intima-media thickness (cIMT), are linked to cerebral microbleeds (CMBs). This suggests potential clinical markers for subclinical small vessel disease.

Area of Science:

  • Neurology
  • Cardiovascular Science
  • Medical Biomarkers

Background:

  • Cerebral microbleeds (CMBs) indicate subclinical cerebral small vessel disease.
  • Large artery atherosclerosis (LAA) is a significant risk factor for cerebrovascular events.
  • Identifying early markers for CMBs is crucial for risk stratification and intervention.

Purpose of the Study:

  • To systematically review and meta-analyze evidence linking biomarkers of LAA to CMBs.
  • To determine if arterial stenosis and carotid intima-media thickness (cIMT) are associated with CMBs.
  • To explore the potential of LAA biomarkers as indicators of haemorrhage-prone cerebral small vessel disease.

Main Methods:

  • Systematic literature search of PubMed, MEDLINE, Web of Science, EMBASE, and Cochrane Library up to July 2016.
  • Meta-analysis of 8 studies (7160 participants) to assess the association between arterial stenosis and CMBs (OR, 95% CI).
  • Meta-analysis to evaluate the association between cIMT and CMBs using standardized mean difference (SMD).

Main Results:

  • A significant association was found between arterial stenosis >50% and the presence of CMBs (OR 1.95, 95% CI 1.13 to 3.36).
  • Patients with CMBs were more likely to have a greater cIMT (SMD 0.20, 95% CI 0.11 to 0.28).
  • Heterogeneity and publication bias were assessed across the included studies.

Conclusions:

  • This meta-analysis confirms a relationship between large artery atherosclerosis and cerebral microbleeds.
  • Biomarkers of LAA, including stenosis and cIMT, may serve as clinical markers for subclinical CMBs.
  • Further research is warranted to elucidate the impact of atherosclerosis on CMBs and its therapeutic implications.
Abstract

Keywords:
Atherosclerosisarterial stenosiscerebral microbleedsintima-media thickness

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