Predictors of Ischemic Events Secondary to Cervicocerebral Artery Dissection
Abstract Objective: To identify the predictors of ischemic events secondary to cervicocerebral artery dissection (CAD). Methods: Consecutive patients with cervicocerebral artery dissection from 2010 to 2017 were registered as study subjects, who were classified as patients with and without ischemic events. Clinical data were collected prospectively, such as demographics, vascular risk factors, headache and neck pain, dissection site and laboratory test. A case-control study was performed to compare the clinical data between two groups. Results: A total of 130 patients with cervicocerebral artery dissection were included, in which 70.0% (91/130) suffered from ischemic events, including 81 ischemic strokes and 10 transient ischemic attacks. There were 46.2% (42/91) and 25.6% (10/39) of the artery dissections located in the anterior circulation in the CAD patients with and without ischemic events respectively (p=0.029). The average level of HDL was (1.14±0.38) mmol/L in the CAD patients with ischemic events, and (1.28±0.48) mmol/L in the CAD patients without ischemic events (p=0.083). However, no significant differences were found in the other clinical data. Multivariate logistic regression analysis showed that there was a positive correlation between anterior circulation and ischemic events (OR=3.204, 95% CI 1.305-7.863, p=0.011) and HDL level was negatively correlated with ischemic events (OR=0.335, 95% CI 0.130-0.867, p=0.024) in CAD patients. Conclusion: Ischemic events are common complications of cerebrovascular disease in CAD patients, especially for those with an artery dissection located in the anterior circulation and low serum HDL level. Key Word: cervicocerebral artery dissection, ischemic event, HDL, anterior circulation, predictor