Pooled cohort risk equation and subclinical cerebrovascular diseases

Area of Science:

• Neurology
• Cardiology
• Public Health

Background:

• The 2013 American College of Cardiology/American Heart Association (ACC/AHA) introduced a novel pooled cohort risk (PCR) model for atherosclerotic cardiovascular disease (ASCVD).
• Cerebral large- and small-vessel diseases (cLVD and cSVD) represent significant neurological conditions with varying risk factors.

Purpose of the Study:

• To investigate the association between the ACC/AHA PCR score and the presence and severity of cLVD and cSVD in a healthy population.
• To determine if a higher ASCVD risk score predicts increased cerebrovascular disease burden.

Main Methods:

• A cohort of 2720 health check-up volunteers (2006-2013) was analyzed.
• The 10-year ASCVD risk was calculated using the 2013 ACC/AHA PCR model.
• Cerebral imaging assessed cLVD, lacunes, cerebral microbleeds (CMBs), and white matter hyperintensity (WMH) volume. Multivariable regression analyses were performed.

Main Results:

• In multivariable analysis, higher PCR scores were significantly associated with increased WMH volume (β=0.361, P<0.001).
• PCR scores were also linked to higher odds of cLVD (aOR=1.66, P<0.001), lacunes (aOR=1.80, P<0.001), and CMBs (aOR=1.75, P<0.001).
• A dose-response relationship was observed between PCR score and the burden of cLVD, WMH, lacunes, and CMBs.

Conclusions:

• Elevated ACC/AHA PCR scores are significantly associated with a higher prevalence and burden of cerebral large- and small-vessel diseases.
• The PCR model may serve as a valuable tool for identifying individuals at risk for cerebrovascular pathology beyond traditional atherosclerotic cardiovascular disease endpoints.