Clinical Features of Patients With Cervical Artery Dissection and Fibromuscular Dysplasia-Reference-Cited by-同舟云学术

Clinical Features of Patients With Cervical Artery Dissection and Fibromuscular Dysplasia

Published:2021-03 Issue:3 Volume:52 Page:821-829
ISSN:0039-2499
Container-title:Stroke
language:en
Short-container-title:Stroke

Author:

Bonacina Sonia¹,Grassi Mario²,Zedde Marialuisa¹^ORCID,Zini Andrea³^ORCID,Bersano Anna⁴^ORCID,Gandolfo Carlo⁵^ORCID,Silvestrelli Giorgio⁶,Baracchini Claudio⁷,Cerrato Paolo¹,Lodigiani Corrado⁸,Marcheselli Simona⁹^ORCID,Paciaroni Maurizio¹⁰^ORCID,Rasura Maurizia¹¹,Cappellari Manuel¹²^ORCID,Del Sette Massimo¹³,Cavallini Anna¹⁴^ORCID,Morotti Andrea¹⁵^ORCID,Micieli Giuseppe¹⁶^ORCID,Lotti Enrico Maria¹⁷,DeLodovici Maria Luisa¹⁸,Gentile Mauro³,Magoni Mauro¹⁹,Azzini Cristiano²⁰,Calloni Maria Vittoria²¹,Giorli Elisa²²,Braga Massimiliano²³,La Spina Paolo²⁴,Melis Fabio²⁵,Tassi Rossana²⁶^ORCID,Terruso Valeria²⁷,Calabrò Rocco Salvatore²⁸,Piras Valeria²⁹,Giossi Alessia³⁰,Locatelli Martina¹,Mazzoleni Valentina¹,Pezzini Debora¹,Sanguigni Sandro³¹,Zanferrari Carla³²,Mannino Marina³³,Colombo Irene³⁴,Dallocchio Carlo³⁵,Nencini Patrizia³⁶,Bignamini Valeria³⁷,Adami Alessandro³⁸,Magni Eugenio³⁹^ORCID,Bella Rita⁴⁰^ORCID,Padovani Alessandro¹,Pezzini Alessandro¹^ORCID,Pascarella Rosario,Sessa Maria,Scelzo Emma,Bandettini di Poggio Monica Laura,Boscain Francesca,Naldi Andrea,Caso Valeria,Gamba Massimo,Casetta Ilaria,Forlivesi Stefano,Tomelleri Giampaolo,Schirinzi Elena,Verrengia Elena,Nuzzaco Graziamaria,Beretta Sandro,Musolino Rossella,Imperiale Daniele,Acampa Maurizio,Gasparro Antonio,Melis Maurizio,Fisicaro Francesco,Santilli Ignazio,Corato Manuel,Padroni Marina,Leuci Eleonora,Mazzacane Federico,Gaiani Alessandra,Assenza Federica,Cariddi Lucia Princiotta,Sarti Cristina,Monaco Serena,Puca Emanuele,Ciolli Ludovico

Affiliation:

1. Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Italy (S.B., M.L., V.M., D.P., A. Padovani, A. Pezzini).

2. Dipartimento di Scienze del Sistema Nervoso e del Comportamento, Unità di Statistica Medica e Genomica, Università di Pavia, Italy (M. Grassi).

3. IRCCS Istituto di Scienze Neurologiche di Bologna, UOC Neurologia e Rete Stroke Metropolitana, Ospedale Maggiore, Bologna, Italy (A.Z., M. Gentile).

4. U.O. Malattie Cerebrovascolari, Fondazione IRCCS Istituto Neurologico “Carlo Besta,” Milano, Italy (A.B.).

5. Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili, Università di Genova, Italy (C.G.).

6. Dipartimento di Neuroscienze, Stroke Unit, Ospedale Carlo Poma, Mantova, Italy (G.S.).

7. UOSD Stroke Unit e Laboratorio di Neurosonologia, Azienda Ospedale–Università di Padova, Italy (C.B.).

8. Centro Trombosi, IRCCS Humanitas Research Hospital, Rozzano-Milano, Italy (C.L.).

9. Neurologia d’Urgenza e Stroke Unit, IRCCS Humanitas Research Hospital, Rozzano-Milano, Italy (S.M.).

10. Stroke Unit and Divisione di Medicina Cardiovascolare, Università di Perugia, Italy (M.P.).

11. Stroke Unit, Azienda Ospedaliera Sant’Andrea, Università “La Sapienza,” Roma, Italy (M.R.).

12. Stroke Unit, Azienda Ospedaliera Universitaria Integrata Borgo Trento, Verona, Italy (M.C.).

13. U.O. di Neurologia, Ospedale Galliera, Genova, Italy (M.D.S.).

14. UC Malattie Cerebrovascolari e Stroke Unit (A.C.), IRCCS Fondazione Istituto “C. Mondino,” Pavia, Italy.

15. UO Neurologia, ASST della Valle Camonica, Esine, Italy (A.M.).

16. Neurologia d’Urgenza (G.M.), IRCCS Fondazione Istituto “C. Mondino,” Pavia, Italy.

17. UOC Neurologia, AUSL Romagna, Ravenna, Italy (E.M.L.).

18. UO Neurologia, Ospedale di Circolo, Università dell’Insubria, Varese, Italy (M.L.D.).

19. Stroke Unit, Neurologia Vascolare, ASST Spedali Civili di Brescia, Italy (M. Magoni).

20. U.O. di Neurologia, Dipartimento di Neuroscienze e Riabilitazione, Azienda Ospedaliero-Universitaria di Ferrara (C.A.).

21. U.O. di Neurologia-Stroke Unit, Ospedale di Legnano, ASST-Ovest Milanese, Milano, Italy (M.V.C.).

22. Unità di Neurologia, Ospedale S. Andrea, La Spezia, Italy (E.G.).

23. UOC Neurologia, ASST Vimercate, Italy (M.B.).

24. UOSD Stroke Unit, Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, Italy (P.L.S.).

25. SS NeuroVascolare Ospedale Maria Vittoria, ASL Città di Torino, Italy (F.M.).

26. UOC Stroke Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy (R.T.).

27. UO Neurologia, Ospedale Villa Sofia, Palermo, Italy (V.T.).

28. Istituto di Ricovero e Cura a Carattere Scientifico, Centro Neurolesi Bonino-Pulejo, Messina, Italy (R.S.C.).

29. SC Neurologia e Stroke Unit, Dipartimento Neuroscienze e Riabilitazione, Azienda Ospedaliera “G. Brotzu,” Cagliari, Italy (V.P.).

30. UO Neurologia, Istituti Ospitalieri, ASST Cremona, Italy (A.G.).

31. Dipartimento di Neurologia, Ospedale “Madonna del Soccorso,” San Benedetto del Tronto, Italy (S.S.).

32. UOC Neurologia-Stroke Unit, ASST Melegnano-Martesana, PO Vizzolo Predabissi, Italy (C.Z.).

33. Stroke Unit, Ospedale Civico, Palermo, Italy (M. Mannino).

34. S.C. Neurologia e Unità Neurovascolare, Ospedale di Desio-ASST Monza, Italy (I.C.).

35. Dipartimento di Area Medica, UOC Neurologia, ASST Pavia, Voghera, Italy (C.D.).

36. Stroke Unit, Università degli Studi di Firenze, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy (P.N.).

37. Stroke Unit, UO Neurologia, Ospedale “S. Chiara,” Trento, Italy (V.B.).

38. Stroke Center, Dipartimento di Neurologia, IRCSS Sacro Cuore Negrar, Verona, Italy (A.A.).

39. UO Neurologia, Istituto Ospedaliero Poliambulanza, Brescia, Italy (E.M.).

40. Dipartimento Di Scienze Mediche e Chirurgiche e Tecnologie Avanzate, Sezione di Neuroscienze, Università di Catania, Italy (R.B.).

Abstract

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.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialised Nursing,Cardiology and Cardiovascular Medicine,Clinical Neurology

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