Researchers have developed a new tool to predict the risk of asymptomatic intracranial atherosclerotic stenosis (aICAS) – a narrowing of the brain’s arteries without any symptoms. This condition can increase the risk of stroke and cognitive decline. The study analyzed data from over 2,500 healthy participants and identified key risk factors like age, blood sugar levels, and carotid artery disease. The researchers used these factors to create a nomogram – a visual tool that can estimate an individual’s risk of developing aICAS. This advance could help doctors identify high-risk patients and intervene early to prevent serious complications. Atherosclerosis, the buildup of plaque in arteries, is a major contributor to strokes and other cardiovascular issues.
Identifying Asymptomatic Brain Artery Narrowing
Asymptomatic intracranial atherosclerotic stenosis (aICAS) refers to a narrowing of the arteries supplying blood to the brain, without any noticeable symptoms. This condition is a significant risk factor for strokes and other cerebrovascular events. However, because aICAS often develops gradually without obvious signs, it can go undetected until it causes serious complications.
The researchers aimed to develop a tool to help identify individuals at high risk of developing aICAS, which could allow for earlier interventions to prevent strokes and cognitive decline. They analyzed data from over 2,500 participants who underwent comprehensive health examinations, including brain imaging and assessments of their vascular health.
Key Risk Factors for aICAS
The study identified several key risk factors for aICAS:
– Age: Older age was a major risk factor, with the prevalence of aICAS increasing with age.
– Blood sugar levels: Higher fasting blood glucose levels were associated with a higher risk of aICAS.
– High blood pressure: Participants with hypertension had a greater likelihood of developing aICAS.
– Carotid artery disease: The presence of plaque buildup in the carotid arteries, which supply blood to the brain, was the strongest predictor of aICAS.
Developing a Predictive Nomogram
Using these risk factors, the researchers developed a nomogram – a visual tool that can estimate an individual’s risk of developing aICAS. The nomogram assigns a numerical score to each risk factor, and the total score can be used to predict the probability of aICAS.
The nomogram demonstrated good accuracy in predicting aICAS risk in the study population. The model was able to discriminate between participants with and without aICAS with an area under the curve (AUC) of 0.78 in the training set. While the performance was slightly lower in the testing set (AUC of 0.65), the nomogram still showed potential utility in clinical practice for assessing aICAS risk.
Implications and Future Directions
This research provides a valuable tool for early identification of individuals at high risk of asymptomatic brain artery narrowing. By recognizing these high-risk patients, healthcare providers can intervene earlier to address modifiable risk factors, such as blood sugar and blood pressure control, and potentially prevent the development of aICAS and its associated complications.
The researchers note that further validation in larger, multi-center studies is needed to confirm the nomogram’s generalizability. Expanding the model to include additional risk factors, such as genetic and inflammatory markers, may also improve its predictive accuracy. Nonetheless, this study represents an important step forward in improving the early detection and management of this important, yet often overlooked, condition.
Author credit: This article is based on research by Wenbo Li, Xiaonan Liu, Yang Liu, Jie Liu, Qirui Guo, Jing Li, Wei Zheng, Longyou Zhang, Ying Zhang, Yin Hong, Anxin Wang, Huaguang Zheng.
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