Coronary Artery Atherosclerosis And Cerebral Microbleeds:the Study Of Relationship And Risk Factors

Objectice:Recently,Researchs have shown that atherosclerosis is associated with abnormal brain MRI changes.However,there are few date concerning the relationship between coronary artety atherosclerosis and cerebral microbleeds(CMBs).We investigated the relationship between coronary artety atherosclerosis and CMBs,and the risk factors for CMBs in patients with coronary artery atherosclerosis.Method:We selected people who completed the head 3.0T MRI and coronary artery CTA examinations from 2017.05 to 2018.05 in the "Lishui City Vascular Health Community Cohort Study" project,Which is a precise medcial research of National Key Research plan in the Lishui Hospital of Zhejiang University.The coronary artery atherosclerosis group(n=393)and the no coronary artery atherosclerosis group(n=576)were distinguished.Accroding to whether the presence of CMBs by further analysis of the MRI results in the coronary artery atherosclerosis group,the group was divided into coronary artery atherosclerosis with CMBs group(n=73)and simple coronary artery atherosclerosis group(n=320).Basic information,laboratory results,previous disease history and medication history were collected.Then we analysised the coronary artery CTA images and classified the plaque by the plaque characteristics,We use segment involvement score(SIS)and segmental stenosis score(SSS)assess the extent of Coronary artery atherosclerosis plaque burden,analyze the correlation between SIS,SSS and CMBs,and study the risk factors for CMBs in people with coronary artery atherosclerosis by binary logistic regression analysis.Result:A total of 969 patients were enrolled in the study,including 576 patients without coronary artery atherosclerosis and 393 patients with coronary artery atherosclerosis which including 73 patients with CMBs.The coronary artery atherosclerosis with CMBs group including 45 patients with deep CMBs and 28 patients with lobar CMBs..The prevalence of CMBs in patients with coronary artery atherosclerosis was 18.6%in this study,which was significantly higher than that in the no coronary artery atherosclerosis group(13.5%,P=0.034).There was a positive correlation between SIS and the bleeding numbers of CMBs in patients with coronary artery atherosclerosis(r=0.181,P<0.001).Compared with patients with simple coronary atherosclerosis,there were statistical differences in diastolic blood pressure,SIS,history of stroke,history of hypertension,and antihypertensive drug use in patients with CMBs.Binary logistic regression showed that hypertension(OR=2.383,p=0.003)and SIS increase(OR=1.349,p=0.019)were independent risk factors for CMBs in patients with coronary artery atherosclerosis,And only increasing the risk of deep CMBs(OR?2.978,p?0.004;OR=1.503,p=0.005),but not related to only lobar CMBs.In addition,the risk of deep CMBs was significantly increased in patients with bilateral carotid plaques compared with those without carotid plaques(OR=3.177,p=0.027).Conclusion:This study demonstrated that CMBs have a higher prevalence in patients with coronary artery atherosclerosis,and the number of coronary atherosclerosis SIS is positively correlated with the number of bleeding points in CMBs.Coronary artery atherosclerosis with more segments and hypertension are independent risk factors for CMBs in patients with coronary artery atherosclerosis,and only associated with deep CMBs.