Neurointervention.  2019 Mar;14(1):43-52. 10.5469/neuroint.2018.01123.

Cigarette Smoking Preferentially Affects Intracranial Vessels in Young Males: A Propensity-Score Matching Analysis

Affiliations
  • 1Department of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea. dcsuh@amc.seoul.kr
  • 2Department of Neurology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
  • 3Department of Radiology, Chung-Ang University College of Medicine, Seoul, Korea.
  • 4Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
  • 5Department of Interventional Radiology, Taizhou People’s Hospital, Taizhou, China.
  • 6Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
  • 7Department of Family Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.

Abstract

PURPOSE
Cigarette smoking (CS) is one of the major risk factors of cerebral atherosclerotic disease, however, its level of contribution to extracranial and intracranial atherosclerotic stenosis (ECAS and ICAS) was not fully revealed yet. The purpose of our study was to assess the association of CS to cerebral atherosclerosis along with other risk factors.
MATERIALS AND METHODS
All consecutive patients who were angiographically confirmed with severe symptomatic cerebral atherosclerotic disease between January 2002 and December 2012 were included in this study. Multivariate logistic regression analyses were performed to identify risk factors for ECAS and ICAS. Thereafter, CS group were compared to non-CS group in the entire study population and in a propensity-score matched population with two different age-subgroups.
RESULTS
Of 1709 enrolled patients, 794 (46.5%) had extracranial (EC) lesions and the other 915 (53.5%) had intracranial (IC) lesions. CS group had more EC lesions (55.8% vs. 35.3%, P<0.001) whereas young age group (<50 years) had more IC lesion (84.5% vs. 47.6%, P<0.001). In multivariate analysis, seven variables including CS, male, old age, coronary heart disease, higher erythrocyte sedimentation rate, multiple lesions, and anterior lesion were independently associated with ECAS. In the propensity-score matched CS group had significant more EC lesion compared to non-CS group (65.7% vs. 47.9%) only in the old age subgroup.
CONCLUSION
In contrast to a significant association between CS and severe symptomatic ECAS shown in old population, young patients did not show this association and showed relatively higher preference of ICAS.

Keyword

Atherosclerosis; Risk factors; Cerebrovascular circulation; Smoking

MeSH Terms

Atherosclerosis
Blood Sedimentation
Cerebrovascular Circulation
Constriction, Pathologic
Coronary Disease
Humans
Intracranial Arteriosclerosis
Logistic Models
Male*
Multivariate Analysis
Risk Factors
Smoking*
Tobacco Products*
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