Ya-Hui Ma1, Xin-Yi Leng2, Yi Dong3, Wei Xu4, Xi-Peng Cao5, Xi Ji1, Hui-Fu Wang4, Lan Tan6, Jin-Tai Yu7. 1. Department of Neurology, Qingdao Municipal Hospital, Dalian Medical University, Dalian, China. 2. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China. 3. Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China. 4. Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China. 5. Clinical Research Center, Qingdao Municipal Hospital, Qingdao University, Qingdao, China. 6. Department of Neurology, Qingdao Municipal Hospital, Dalian Medical University, Dalian, China; Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China. Electronic address: dr.tanlan@163.com. 7. Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China; Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China. Electronic address: yu-jintai@163.com.
Abstract
BACKGROUND AND AIMS: Intracranial atherosclerosis (ICAS) is a predictable and preventable condition, but existing evidence concerning its risk factors has not been quantitatively assessed. The aim of this meta-analysis is to identify the non-modifiable and modifiable risk factors for ICAS. METHODS: PubMed and EMBASE were searched (1995-May 15, 2018) for cross-sectional and longitudinal studies exploring risk factors for ICAS. The risk estimates and 95% confidence intervals (CIs) in multivariate analysis were aggregated using random-effect models. RESULTS: Thirty-four studies comprising 59,736 subjects met the inclusion criteria for the systematic review involving thirty-one risk or protective factors. Seven factors were associated with ICAS, as suggested by the meta-analysis, including advanced age (odds ratio (OR) 1.05, 95% CI 1.03-1.08), metabolic syndrome (OR 2.13, 95% CI 1.35-3.37), diabetes mellitus (OR 1.98, 95% CI 1.69-2.31), hypertension (OR 1.97, 95% CI 1.69-2.31), dyslipidemia (OR 1.29, 95% CI 1.04-1.59), high levels of low-density lipoprotein cholesterol (OR 1.06, 95% CI 1.00-1.12) and high levels of apolipoprotein A1 (OR 0.34, 95% CI 0.15-0.75). The subgroup analysis for study populations indicated advanced age, metabolic syndrome, diabetes mellitus and hypertension as an elevated risk of ICAS among community subjects and stroke patients; according to the subgroup analysis for ethnicity, similar associations remained in Asians, but only metabolic syndrome and diabetes mellitus were correlated with ICAS in Caucasians. CONCLUSIONS: Individuals with advanced age, metabolic syndrome, diabetes mellitus, hypertension and dyslipidemia might have a higher risk of ICAS, whereas high levels of apolipoprotein A1 might protect against ICAS.
BACKGROUND AND AIMS: Intracranial atherosclerosis (ICAS) is a predictable and preventable condition, but existing evidence concerning its risk factors has not been quantitatively assessed. The aim of this meta-analysis is to identify the non-modifiable and modifiable risk factors for ICAS. METHODS: PubMed and EMBASE were searched (1995-May 15, 2018) for cross-sectional and longitudinal studies exploring risk factors for ICAS. The risk estimates and 95% confidence intervals (CIs) in multivariate analysis were aggregated using random-effect models. RESULTS: Thirty-four studies comprising 59,736 subjects met the inclusion criteria for the systematic review involving thirty-one risk or protective factors. Seven factors were associated with ICAS, as suggested by the meta-analysis, including advanced age (odds ratio (OR) 1.05, 95% CI 1.03-1.08), metabolic syndrome (OR 2.13, 95% CI 1.35-3.37), diabetes mellitus (OR 1.98, 95% CI 1.69-2.31), hypertension (OR 1.97, 95% CI 1.69-2.31), dyslipidemia (OR 1.29, 95% CI 1.04-1.59), high levels of low-density lipoprotein cholesterol (OR 1.06, 95% CI 1.00-1.12) and high levels of apolipoprotein A1 (OR 0.34, 95% CI 0.15-0.75). The subgroup analysis for study populations indicated advanced age, metabolic syndrome, diabetes mellitus and hypertension as an elevated risk of ICAS among community subjects and strokepatients; according to the subgroup analysis for ethnicity, similar associations remained in Asians, but only metabolic syndrome and diabetes mellitus were correlated with ICAS in Caucasians. CONCLUSIONS: Individuals with advanced age, metabolic syndrome, diabetes mellitus, hypertension and dyslipidemia might have a higher risk of ICAS, whereas high levels of apolipoprotein A1 might protect against ICAS.
Authors: Shyam Prabhakaran; David S Liebeskind; George Cotsonis; Azhar Nizam; Edward Feldmann; Rajbeer S Sangha; Iszet Campo-Bustillo; Jose G Romano Journal: J Stroke Cerebrovasc Dis Date: 2021-10-26 Impact factor: 2.136
Authors: Mengmeng Shi; Xinyi Leng; Ying Li; Zihan Chen; Ye Cao; Tiffany Chung; Bonaventure Ym Ip; Vincent Hl Ip; Yannie Oy Soo; Florence Sy Fan; Sze Ho Ma; Karen Ma; Anne Y Y Chan; Lisa Wc Au; Howan Leung; Alexander Y Lau; Vincent Ct Mok; Kwong Wai Choy; Zirui Dong; Thomas W Leung Journal: Stroke Vasc Neurol Date: 2021-12-08
Authors: S Voigt; Hja van Os; Maa van Walderveen; I C van der Schaaf; L J Kappelle; A Broersen; B K Velthuis; P A de Jong; R Kockelkoren; N D Kruyt; A Algra; Mjh Wermer Journal: Int J Stroke Date: 2020-09-02 Impact factor: 5.266