Morphometric measurements of extracranial and intracranial atherosclerotic disease: A population-based autopsy study

• Published in: Atherosclerosis 2018-03, Vol.270, p.218-223
• Main Authors: Suemoto, Claudia K., Grinberg, Lea T., Leite, Renata E.P., Ferretti-Rebustini, Renata E.L., Jacob-Filho, Wilson, Yaffe, Kristine, Nitrini, Ricardo, Pasqualucci, Carlos A.
• Format: Article
• Language: English
• Subjects: Atherosclerosis; Carotid arteries; Cerebral arteries; Epidemiology; Risk factors
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2017.12.015

Intracranial (IAD) and extracranial atherosclerotic diseases (EAD) have been mostly investigated using imaging methods. Autopsy studies allow for a direct and complete evaluation of the atherosclerotic disease. We aimed to investigate the frequency of IAD and EAD, their association, and related risk profiles in a large cross-sectional autopsy study. We measured the intima-media thickness and stenosis of the common (CCA) and internal carotid arteries (ICA), using morphometric measurements. The main outcome was stenosis (≥50%) in the artery with the largest obstruction among the 12 cerebral arteries. We used multivariable logistic regression models to investigate the association between EAD and IAD. In 661 participants (mean age = 71.3 ± 11.7 y, 51% male), stenosis was more common in IAD than in EAD (59% vs. 51%). EAD was associated with Caucasian race, hypertension, and smoking, while IAD was associated with older age, less years of education, hypertension, diabetes, and a previous history of stroke. Stenosis in CCA and ICA was associated with more than two times the odds of having stenosis in the intracranial arteries (CCA: OR = 2.32, 95% CI = 1.64; 3.28; ICA: OR = 2.51, 95% CI = 1.76; 3.57). In this population-based autopsy study, IAD was common, even more common than EAD, but correlated with EAD. •Extracranial and intracranial atherosclerosis have been investigated mostly with imaging methods.•Autopsy studies allow for direct measurements of atherosclerosis.•In 661 participants, we evaluated extracranial and intracranial atherosclerosis.•Intracranial atherosclerosis was more common than extracranial atherosclerosis, and they had different risk profiles.•Participants with stenosis in the extracranial arteries had more than two times the odds of having intracranial stenosis.