Cardiovascular risk scoring and magnetic resonance imaging detected subclinical cerebrovascular disease

Area of Science:

• Cardiovascular epidemiology
• Neuroimaging
• Public health

Background:

• Cardiovascular risk factors are crucial for primary prevention strategies.
• Subclinical cerebrovascular disease detected by magnetic resonance imaging (MRI) may indicate future cardiovascular events.
• The association between traditional risk scores and specific MRI markers of cerebrovascular disease requires further investigation.

Purpose of the Study:

• To assess the association between simple cardiovascular risk scores and MRI-detected subclinical cerebrovascular disease.
• To evaluate the relationship between the INTERHEART Risk Score (IHRS) and Framingham Risk Score with carotid wall volume (CWV), carotid intraplaque hemorrhage (IPH), and silent brain infarction (SBI).

Main Methods:

• A population-based cohort of 7594 adults without prior cardiovascular disease (CVD) was recruited between 2014 and 2018.
• Participants underwent risk factor assessment and non-contrast enhanced MRI of the carotid arteries and brain.
• The INTERHEART Risk Score (IHRS) and Framingham Risk Score were calculated and correlated with MRI measures of CWV, IPH, and SBI.

Main Results:

• Higher IHRS was significantly associated with increased CWV, IPH, and SBI.
• Each 5-point increase in IHRS correlated with a 9 mm³ increase in CWV, a 23% increase in IPH, and a 32% increase in SBI.
• The Framingham Risk Score also showed significant associations with CWV, IPH, and SBI, with CWV being additive and independent.

Conclusions:

• Simple cardiovascular risk scores are significantly associated with MRI-detected subclinical cerebrovascular disease in asymptomatic adults.
• These findings support the utility of traditional risk scores in identifying individuals with underlying cerebrovascular damage.
• Cardiovascular risk stratification may benefit from incorporating imaging markers of subclinical disease.