Abstract
Background: Together with cerebral small vessel disease (CSVD), large vessel atherosclerosis is considered to be an equally important risk factor in the progression of vascular cognitive impairment. This article aims to investigate whether carotid atherosclerotic calcification is associated with the increased risk of post-stroke cognitive impairment (PSCI).Methods: A total of 128 patients (mean age: 62.1 ± 12.2 years, 37 women) suffering from ischemic stroke underwent brain/neck computer tomography angiography examination. The presence and characteristic of carotid calcification (size, number and location) were analyzed on computer tomography angiography. White matter hyperintensity (WMH) was assessed using Fazekas scales. PSCI was diagnosed based on a battery of neuropsychological assessments implemented 6−12 months after stroke.Results: Among 128 patients, 26 developed post-stroke dementia and 96 had carotid calcification. Logistic regression found carotid calcification (odds ratio [OR] = 7.15, 95% confidence interval [CI]: 1.07–47.69) and carotid artery stenosis (OR = 6.42, 95% CI: 1.03–40.15) both significantly increased the risk for post-stroke dementia. Moreover, multiple, thick/mixed, and surface calcifications exhibited an increasing trend in PSCI (Ptrend = 0.004, 0.016, 0.045, respectively). The prediction model for post-stroke dementia including carotid calcification (area under curve = 0.67), WMH (area under curve = 0.67) and other covariates yielded an area under curve (AUC) of 0.90 (95% CI: 0.82–0.99).Conclusion: Our findings demonstrated that the quantity and location of carotid calcifications were independent indicators for PSCI. The significant role of large vessel atherosclerosis in PSCI should be concerned in future study.
Highlights
Stroke is considered to be one of the most widespread and serious cerebrovascular diseases affecting millions of people worldwide
One hundred seventy-nine participants who met the criteria from June 2017 to May 2018 were included in this study
No significant difference between the baseline profiles of participants involved in this study and those lost in follow-up was found (Supplementary Table 1)
Summary
Stroke is considered to be one of the most widespread and serious cerebrovascular diseases affecting millions of people worldwide. Several factors, including age, education level, vascular risk factors, extent of stroke, and neuroimaging features, are considered to be important determinants of PSCI (Rasquin et al, 2004; Leys et al, 2005; Lu et al, 2016). CSVD is often accompanied by pathological changes in large arteries, the relationship between large vessel diseases (such as stenosis, slow blood flow, malformation, or poor collateral circulation) and PSCI remains ambiguous. Together with cerebral small vessel disease (CSVD), large vessel atherosclerosis is considered to be an important risk factor in the progression of vascular cognitive impairment. This article aims to investigate whether carotid atherosclerotic calcification is associated with the increased risk of post-stroke cognitive impairment (PSCI)
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