Yonsei Med J.  2010 May;51(3):318-325. 10.3349/ymj.2010.51.3.318.

Increasing Frequency and Burden of Cerebral Artery Atherosclerosis in Korean Stroke Patients

• Kim YD
• Choi HY
• Cho HJ
• Cha MJ
• Nam CM
• Han SW
• Nam HS
• Heo JH

• KMID: 1074981
• DOI: http://doi.org/10.3349/ymj.2010.51.3.318

Abstract

PURPOSE
Koreans have been undergoing rapid lifestyle changes that may have an effect on patterns of cerebral artery atherosclerosis. This study was aimed at determining the frequency and distribution of atherosclerosis in the cerebral arteries and associated temporal changes over the past eight-year period among Korean stroke patients.
MATERIALS AND METHODS
By using stroke registry data registered between April 1999 and March 2007, we investigated the presence, severity, and location of cerebral artery atherosclerosis as determined by angiographic findings. Their annual patterns and association with vascular risk factors were investigated.
RESULTS
Of 1,955 patients, 1,517 patients (77.6%) demonstrated atherosclerosis in one or more arteries. A significantly increasing trend of atherosclerosis was observed during the past eight years, which was ascribed to an increase of combined extracranial (EC) and intracranial (IC) atherosclerosis. The number of atherosclerotic arteries increased as the number of risk factors increased. In the multivariate analysis, the year and vascular risk factors were independent predictors of the presence of atherosclerosis.
CONCLUSION
We found that the atherosclerotic burden has been increasing for the past eight years in Korean stroke patients, particularly the combined EC and IC subtype. Lifestyle changes and increase in vascular risk factors may be contributing factors.

Keyword

Cerebrovascular disorders; atherosclerosis; risk factors; epidemiology

MeSH Terms

Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Asian Continental Ancestry Group
Child
*Cost of Illness
Diabetes Mellitus/epidemiology/physiopathology
Female
Humans
Hypertension/epidemiology/physiopathology
Intracranial Arteriosclerosis/*epidemiology/etiology/pathology
Korea/epidemiology
Male
Middle Aged
Multivariate Analysis
Risk Factors
Young Adult

Figure

• 

  Fig. 1 Flow chart of patient selection and grouping. EC, extracranial; IC, intracranial.

• 

  Fig. 2 Temporal changes in the frequency of atherosclerosis in the cerebral arteries in 1,955 patients excluding those with potential cardiac sources of embolism (PCSE) (A), and in 2,657 patients including those with PCSE (B). The frequencies of atherosclerosis in both study groups have been increasing during the eight-year study period. The proportion of involved sites is expressed as the percentage in each subgroup.

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