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Cerebral small vessel disease score and atherosclerosis burden - A population study in community-dwelling older
Oscar H Del Brutto1, Robertino M Mera2, Victor J Del Brutto3
1School of Medicine, Universidad Espíritu Santo - Ecuador, Samborondón, Ecuador.
Insights
Higher cerebral small vessel disease (cSVD) scores are linked to increased large artery atherosclerosis (LAA) burden, particularly when multiple vascular beds are affected. This association is most pronounced in older adults with severe cSVD and extensive LAA.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Geriatrics
Background:
- Cerebral small vessel disease (cSVD) and large artery atherosclerosis (LAA) are distinct but potentially interconnected vascular pathologies.
- Previous research has explored links between individual markers of cSVD and LAA in specific vascular territories.
Purpose of the Study:
- To investigate the association between categories of the cSVD score and the burden of LAA across multiple vascular beds.
- To examine this relationship in a cohort of community-dwelling older adults.
Main Methods:
- Utilized data from the Atahualpa Project, including 333 individuals aged 60 years and older.
- Assessed cSVD score and LAA involvement in peripheral, carotid extracranial, and intracranial vascular beds.
- Employed multivariate logistic regression models to determine independent associations.
Main Results:
- A significant positive association was observed between higher cSVD score categories and increased LAA burden across multiple vascular beds.
- This association became particularly evident with severe cSVD (3-4 points) and involvement of two or three vascular beds.
Conclusions:
- Robust associations exist between the cSVD score and LAA burden in older adults.
- The relationship is most apparent at the extremes of both cSVD severity and LAA involvement across vascular territories.
Objective:
Cerebral small vessel disease (cSVD) and large artery atherosclerosis (LAA) are related to different pathogenetic mechanisms. However, relationships between single biomarkers of cSVD and LAA affecting isolated vascular beds have been reported. Using the Atahualpa Project cohort, we aimed to assess the association between cSVD score categories and LAA burden in community-dwelling older adults.
Patients And Methods:
Atahualpa individuals aged ≥60 years undergoing assessment of the cSVD score and LAA in the peripheral, carotid extracranial, and intracranial vascular beds (n = 333) were included. Multivariate models were fitted to assess independent associations between the cSVD score and LAA burden.
Results:
The cSVD score was 0 points in 62 % individuals, 1 point in 19 %, 2 points in 13 %, and 3-4 points in 7 %. LAA involved the extracranial carotid bed in 43 % individuals, the intracranial bed in 36 %, and the peripheral bed in 20 %. One vascular bed was involved in 111 (33 %) individuals, two beds in 75 (23 %), and three beds in 23 (7 %). The remaining 124 (37 %) had no atherosclerosis. Ordinal logistic regression models showed progressively greater associations between higher categories of cSVD score and the odds of having more beds involved with LAA. Multinomial logistic regression models showed associations between categories of cSVD score and LAA burden, but only when two or three vascular beds were involved.
Conclusion:
This study demonstrates robust associations between the cSVD score and LAA, which become evident at the upper end of the spectrum of cSVD score (3-4 points) and LAA burden (2-3 vascular beds involved).
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