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Abstract Details

Cerebral Small Vessel Disease and Major Adverse Cardiovascular Events: The Framingham Heart Study
Cerebrovascular Disease and Interventional Neurology
S30 - Stroke Risk Factors, Outcomes, and Prevention (3:42 PM-3:54 PM)
002
The effect of neurovascular health on cardiovascular outcomes is not well-known. One neurological risk factor is CSVD, and studying relations to MACE could aid with risk stratification and targeted treatment for disease prevention.
To investigate the association between cerebral small vessel disease (CSVD) and incidence of major adverse cardiovascular events (MACE) in a healthy, community-dwelling population.
We included 3263 Framingham Heart Study participants free of stroke and dementia. CSVD was assessed on brain MRI—considering covert infarcts, cerebral microbleeds, cortical superficial siderosis, high perivascular space burden, and extensive white matter hyperintensities—with 1 point assigned for each marker, to categorize CSVD scores as 0, 1, 2, or 3+. MACE consisted of a composite outcome and three components: stroke, myocardial infarction, and cardiovascular death. Cox regression analysis was used with models adjusted for age, sex, cohort, MRI-exam cycle time interval, and vascular risk factors.
Presence of CSVD was observed in 30.5% of the participants (72.4% CSVD score of 1, 22.2% score of 2, 5.4% score of 3+). Participants with CSVD scores of 1 or 2 had about 1.5 times higher risk of any MACE events (95%CI 1.17-1.81) after multivariable adjusted analyses. There was 1.5-fold increased risk of cardiovascular death (95%CI 1.15-1.93), with risk rising steadily as the CSVD burden increased from 1 to 3+. Similarly, higher stroke risk was seen in patients with CSVD score of 1 (HR 1.57, 95%CI 1.04, 2.35), also increasing as CSVD burden increased. There was numerically higher risk among CSVD patients with scores of 1 or 2 of having a myocardial infarction, but not reaching statistical significance.
CSVD burden is associated with MACE risk in community-dwelling individuals, suggesting that neurovascular health may be a useful predictor of cardiovascular health and could be a target for MACE prevention.
Authors/Disclosures
Riya Manchanda
PRESENTER 		Miss Manchanda has nothing to disclose.
Adlin Pinheiro, MA Ms. Pinheiro has nothing to disclose.
Hugo Javier Aparicio, MD, MPH (Boston University) Dr. Aparicio has received research support from 好色先生. Dr. Aparicio has received research support from Alzheimer's Association. Dr. Aparicio has received research support from National Institutes of Health. Dr. Aparicio has received personal compensation in the range of $10,000-$49,999 for serving as a expert panelist for the Memory & Healthy Aging Program with Cedars-Sinai.
Vasileios-Arsenios Lioutas, MD (Beth Israel Deaconess Medical Center, Department of Neurology) Dr. Lioutas has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Qmetis. Dr. Lioutas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mindray. The institution of Dr. Lioutas has received research support from NIH. The institution of Dr. Lioutas has received research support from Alzheimer's Association.
Alexa Beiser Alexa Beiser has nothing to disclose.
Oluchi S. Ekenze Ms. Ekenze has nothing to disclose.
Emelia J. Benjamin, MD, ScM Prof. Benjamin has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. The institution of Prof. Benjamin has received research support from NIH. Prof. Benjamin has received personal compensation in the range of $100,000-$499,999 for serving as a Faculty with Boston University.
Charles S. DeCarli, MD, FAAN (UC Davis Health - Dept of NeurologyAlzheimer's Disease Research Center) Dr. DeCarli has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. The institution of Dr. DeCarli has received research support from NIH.
Sudha Seshadri, MD, FAAN (Glenn Biggs Institute for Alzheimer'S and Neurodegenerative Diseases) Dr. Seshadri has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Seshadri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. The institution of Dr. Seshadri has received research support from NIH. The institution of Dr. Seshadri has received research support from Alzheimer Association.
Serkalem Demissie, PhD Prof. Demissie has nothing to disclose.
Jose R. Romero, MD (Boston University School of Medicine - Boston Medical Center) The institution of Dr. Romero has received research support from NIH/NIA.