TY - JOUR
T1 - Clinical Features of Patients With Cervical Artery Dissection and Fibromuscular Dysplasia
AU - Bonacina, Sonia
AU - Grassi, Mario
AU - Zedde, Marialuisa
AU - Zini, Andrea
AU - Bersano, Anna
AU - Gandolfo, Carlo
AU - Silvestrelli, Giorgio
AU - Baracchini, Claudio
AU - Cerrato, Paolo
AU - Lodigiani, Corrado
AU - Marcheselli, Simona
AU - Paciaroni, Maurizio
AU - Rasura, Maurizia
AU - Cappellari, Manuel
AU - Del Sette, Massimo
AU - Cavallini, Anna
AU - Morotti, Andrea
AU - Micieli, Giuseppe
AU - Lotti, Enrico Maria
AU - DeLodovici, Maria Luisa
AU - Gentile, Mauro
AU - Magoni, Mauro
AU - Azzini, Cristiano
AU - Calloni, Maria Vittoria
AU - Giorli, Elisa
AU - Braga, Massimiliano
AU - La Spina, Paolo
AU - Melis, Fabio
AU - Tassi, Rossana
AU - Terruso, Valeria
AU - Calabrò, Rocco Salvatore
AU - Piras, Valeria
AU - Giossi, Alessia
AU - Locatelli, Martina
AU - Mazzoleni, Valentina
AU - Pezzini, Debora
AU - Sanguigni, Sandro
AU - Zanferrari, Carla
AU - Mannino, Marina
AU - Colombo, Irene
AU - Dallocchio, Carlo
AU - Nencini, Patrizia
AU - Bignamini, Valeria
AU - Adami, Alessandro
AU - Magni, Eugenio
AU - Bella, Rita
AU - Padovani, Alessandro
AU - Pezzini, Alessandro
PY - 2021/3
Y1 - 2021/3
N2 - BACKGROUND AND PURPOSE: Observational studies have suggested a link between fibromuscular dysplasia and spontaneous cervical artery dissection (sCeAD). However, whether patients with coexistence of the two conditions have distinctive clinical characteristics has not been extensively investigated.METHODS: In a cohort of consecutive patients with first-ever sCeAD, enrolled in the setting of the multicenter IPSYS CeAD study (Italian Project on Stroke in Young Adults Cervical Artery Dissection) between January 2000 and June 2019, we compared demographic and clinical characteristics, risk factor profile, vascular pathology, and midterm outcome of patients with coexistent cerebrovascular fibromuscular dysplasia (cFMD; cFMD+) with those of patients without cFMD (cFMD-).RESULTS: A total of 1283 sCeAD patients (mean age, 47.8±11.4 years; women, 545 [42.5%]) qualified for the analysis, of whom 103 (8.0%) were diagnosed with cFMD+. In multivariable analysis, history of migraine (odds ratio, 1.78 [95% CI, 1.13-2.79]), the presence of intracranial aneurysms (odds ratio, 8.71 [95% CI, 4.06-18.68]), and the occurrence of minor traumas before the event (odds ratio, 0.48 [95% CI, 0.26-0.89]) were associated with cFMD. After a median follow-up of 34.0 months (25th to 75th percentile, 60.0), 39 (3.3%) patients had recurrent sCeAD events. cFMD+ and history of migraine predicted independently the risk of recurrent sCeAD (hazard ratio, 3.40 [95% CI, 1.58-7.31] and 2.07 [95% CI, 1.06-4.03], respectively) in multivariable Cox proportional hazards analysis.CONCLUSIONS: Risk factor profile of sCeAD patients with cFMD differs from that of patients without cFMD. cFMD and migraine are independent predictors of midterm risk of sCeAD recurrence.
AB - BACKGROUND AND PURPOSE: Observational studies have suggested a link between fibromuscular dysplasia and spontaneous cervical artery dissection (sCeAD). However, whether patients with coexistence of the two conditions have distinctive clinical characteristics has not been extensively investigated.METHODS: In a cohort of consecutive patients with first-ever sCeAD, enrolled in the setting of the multicenter IPSYS CeAD study (Italian Project on Stroke in Young Adults Cervical Artery Dissection) between January 2000 and June 2019, we compared demographic and clinical characteristics, risk factor profile, vascular pathology, and midterm outcome of patients with coexistent cerebrovascular fibromuscular dysplasia (cFMD; cFMD+) with those of patients without cFMD (cFMD-).RESULTS: A total of 1283 sCeAD patients (mean age, 47.8±11.4 years; women, 545 [42.5%]) qualified for the analysis, of whom 103 (8.0%) were diagnosed with cFMD+. In multivariable analysis, history of migraine (odds ratio, 1.78 [95% CI, 1.13-2.79]), the presence of intracranial aneurysms (odds ratio, 8.71 [95% CI, 4.06-18.68]), and the occurrence of minor traumas before the event (odds ratio, 0.48 [95% CI, 0.26-0.89]) were associated with cFMD. After a median follow-up of 34.0 months (25th to 75th percentile, 60.0), 39 (3.3%) patients had recurrent sCeAD events. cFMD+ and history of migraine predicted independently the risk of recurrent sCeAD (hazard ratio, 3.40 [95% CI, 1.58-7.31] and 2.07 [95% CI, 1.06-4.03], respectively) in multivariable Cox proportional hazards analysis.CONCLUSIONS: Risk factor profile of sCeAD patients with cFMD differs from that of patients without cFMD. cFMD and migraine are independent predictors of midterm risk of sCeAD recurrence.
U2 - 10.1161/STROKEAHA.120.031579
DO - 10.1161/STROKEAHA.120.031579
M3 - Article
C2 - 33504192
VL - 52
SP - 821
EP - 829
JO - Stroke
JF - Stroke
SN - 0039-2499
IS - 3
ER -