Cervicocerebral Atherosclerosis Burden Increases Long-Term Mortality in Patients With Ischemic Stroke or Transient...

Area of Science:

• Neurology
• Cardiovascular Medicine
• Radiology

Background:

• Atherosclerosis in arteries supplying the brain is a known risk factor for stroke.
• The impact of the total burden of this atherosclerosis on long-term mortality after acute ischemic stroke or transient ischemic attack remains unclear.

Purpose of the Study:

• To assess the association between the total burden of cervicocerebral artery atherosclerosis and long-term mortality in patients with acute ischemic stroke or transient ischemic attack.
• To determine if the Cervicocerebral Atherosclerosis Burden (CAB) score independently predicts all-cause mortality.

Main Methods:

• Computed tomography angiography was used to image cervicocerebral arteries in 406 patients.
• Atherosclerotic findings were scored across 25 artery segments, summed into a Cervicocerebral Atherosclerosis Burden (CAB) score.
• Mortality data was collected from Statistics Finland over a median follow-up of 7.3 years.

Main Results:

• Patients who died had a significantly higher median CAB score compared to survivors (11 vs. 5).
• Cumulative mortality increased with higher quartiles of the CAB score, reaching 61.4% in the highest quartile.
• Each point increase in CAB score was associated with a 3% increased probability of death, and the highest CAB quartile showed a 2.5-fold increased likelihood of all-cause mortality, even after adjustments.

Conclusions:

• The total burden of atherosclerosis in brain-supplying arteries, as defined by computed tomography angiography, is associated with increased mortality after ischemic stroke or transient ischemic attack.
• The Cervicocerebral Atherosclerosis Burden (CAB) score independently predicts long-term all-cause mortality in this patient population.