Eur J Neurol. 2020 May;27(5):793-799. doi: 10.1111/ene.14155. Epub 2020 Feb 14.

Pooled cohort risk equation and subclinical cerebrovascular diseases.

European journal of neurology

K-W Nam, H-M Kwon, H-Y Jeong, J-H Park, H Kwon, S-M Jeong

PMID: 31994781 DOI: 10.1111/ene.14155

Abstract

BACKGROUND AND PURPOSE: In 2013, the American College of Cardiology/American Heart Association (ACC/AHA) introduced a novel pooled cohort risk (PCR) model for atherosclerotic cardiovascular disease. In this study, we evaluated the relationship between the PCR score and cerebral large- and small-vessel diseases (cLVD and cSVD) in a healthy population, METHODS: We assessed consecutive health check-up volunteers from 2006 to 2013. We calculated the estimated 10-year atherosclerotic cardiovascular disease risk as the PCR score based on the 2013 ACC/AHA guidelines. We evaluated both cSVD/cLVD, including the prevalence of cLVD, lacunes and cerebral microbleed (CMB), and the volume of white matter hyperintensity (WMH). In addition to PCR score, the risk factors that were associated with outcome variables at P < 0.10 in univariate analysis were included for further multivariable linear or regression analyses.

RESULTS: A total of 2720 participants were evaluated (mean age, 57 years, male sex, 54%). In multivariable analysis, PCR score was associated with WMH volume [β = 0.361; 95% confidence interval (CI), 0.320-0.402, P < 0.001], cLVD [adjusted odds ratio (aOR), 1.66; 95% CI, 1.29-2.16, P < 0.001], lacunes (aOR, 1.80; 95% CI, 1.52-2.14, P < 0.001) and CMBs (aOR, 1.75; 95% CI, 1.40-2.19, P < 0.001). Furthermore, PCR score also showed dose-response tendencies according to the burden of cLVD, WMH, lacunes and CMB.

CONCLUSIONS: A higher PCR score based on the ACC/AHA guidelines is closely associated with a higher prevalence and burden of cLVD and cSVD.

© 2020 European Academy of Neurology.

Keywords: atherosclerosis; cerebral infarction; magnetic resonance imaging; risk assessments

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MeSH terms

• Asymptomatic Diseases*
• Cerebral Small Vessel Diseases / diagnosis
• Cerebrovascular Disorders / diagnosis
• Cohort Studies
• Female
• Humans
• Leukoaraiosis / diagnosis
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Risk Assessment
• Risk Factors

Publication Types

• Journal Article
• Research Support, Non-U.S. Gov't

Grant support

• Chong Kun Dang pharmaceutical corporation/International