Abstract TP212: Basilar Artery Diameter Is an Independent Predictor Of Incident Cardiovascular Disease

Abstract

Background and purpose: Basilar arterial dolichoectasia, is extreme dilatation and elongation of the basilar artery (BA), is associated with intracranial bleeding, stroke mortality, and cardiovascular death. However, the association between moderate dilatation of the BA and subsequent cardiovascular events remains unclear. The study aims to clarify whether the BA diameter is an independent predictor of incident cardiovascular events. Methods: The study subjects comprised 493 outpatients aged 50 years or older with atherosclerotic risk factors, who underwent brain magnetic resonance imaging (MRI). The short axis of the BA diameter, cerebral infarcts, hemorrhagic lesions, the severity of deep white matter hyperintensities (DWMH), and intracranial steno-occlusive lesions were assessed with MRI and MR angiography. We prospectively evaluated the association between BA diameter and incident cardiovascular events such as cerebrovascular events, coronary heart events, and peripheral arterial events. The Kaplan-Meier method was used to analyze survival, and Cox regression models were used to examine prognostic variables. Results: The BA diameter ranged from 1.1 to 5.2 mm, and only 0.8% of the total patients had dolichoectasia. In the mean follow-up of 6.0 years, 91 patients developed cardiovascular events. BA diameter was independently associated with the cardiovascular events after adjusting for risk factors, stroke lesions, intracranial arterial steno-occlusion, and DWMH. Patients with large BA diameter (>2.7 mm) developed more cardiovascular events compared with those with small BA diameter (≤2.7 mm) (log-rank test; p <0.001). Among the cardiovascular events, BA diameter was most strongly associated with coronary heart events; however, it was not independently associated with cerebrovascular events. Conclusion: BA diameter is independently associated with incident cardiovascular events in high-risk patients. BA diameter could be a new predictive marker of cardiovascular events.