Prevalence of Intracranial Atherosclerotic Stenosis Using High-Resolution Magnetic Resonance Angiography in the General Population: The Atherosclerosis Risk in Communities Study
Muhammad Fareed K Suri, Ye Qiao, Xiaoye Ma, Eliseo Guallar, Jincheng Zhou, Yiyi Zhang, Li Liu, Haitao Chu, Adnan I Qureshi, Alvaro Alonso, Aaron R Folsom, Bruce A Wasserman, Muhammad Fareed K Suri, Ye Qiao, Xiaoye Ma, Eliseo Guallar, Jincheng Zhou, Yiyi Zhang, Li Liu, Haitao Chu, Adnan I Qureshi, Alvaro Alonso, Aaron R Folsom, Bruce A Wasserman
Abstract
Background and purpose: Intracranial atherosclerotic stenosis (ICAS) is a common cause of stroke, but little is known about its epidemiology. We studied the prevalence of ICAS and its association with vascular risk factors using high-resolution magnetic resonance angiography in a US cardiovascular cohort.
Methods: The Atherosclerosis Risk in Communities (ARIC) study recruited participants from 4 US communities from 1987 to 1989. Using stratified sampling, we selected 1980 participants from visit 5 (2011-2013) for high-resolution 3T-magnetic resonance angiography. All images were analyzed in a centralized laboratory, and ICAS was graded as: no stenosis, <50% stenosis, 50% to 69% stenosis, 70% to 99% stenosis, and complete occlusion. We calculated per-vessel and per-person prevalence of ICAS (weighted for n=6538 visit 5 participants) and also estimated the US prevalence. We used multivariable logistic regression to identify variables independently associated with ICAS.
Results: Subjects who had an adequate magnetic resonance angiography (n=1765) were aged 67 to 90 years, 41% were men, 70% were white, and 29% were black. ICAS was prevalent in 31% of participants and 9% had ICAS ≥50%. Estimated US prevalence of ICAS ≥50% for 65 to 90 years old was 8% for whites and 12% for blacks. Older age, black race, higher systolic blood pressure, and higher low-density lipoprotein cholesterol levels were associated with increased odds of ICAS, whereas higher levels of high-density lipoprotein cholesterol and use of cholesterol-lowering medications were associated with decreased odds of ICAS. Body mass index and smoking were not associated with ICAS.
Conclusions: The prevalence of ICAS in older adults is high, and it could be a target for primary prevention of stroke and dementia in this population.
Keywords: intracranial atherosclerosis stenosis; intracranial stenosis; magnetic resonance angiography; prevalence.
© 2016 American Heart Association, Inc.
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Source: PubMed