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KMID : 1155820190140010043
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Neurointervention
2019 Volume.14 No. 1 p.43 ~ p.52
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Cigarette Smoking Preferentially Affects Intracranial Vessels in Young Males: A Propensity-Score Matching Analysis
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Song Yun-Sun
Lee Dong-Whane
Suh Dae-Chul
Kim Joong-Goo
Kim Jae-Kyun
Han Min-Kyu
Liu Hairi
Zhao Lingbo
Kim Eun-Hye
Jung Sung-Chul
Lee Dong-Geun
Koo Hyun-Jung
Kim Min-Ju
Baek Seung-Hee
Hwang Seon-Moon
Kim Bum-Joon
Kim Yeon-Jung
Cho Hong-Jun
Kim Sang-Joon
Jeon Sang-Beom
Kim Jong-S.
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Abstract
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Purpose: Cigarette smoking (CS) is one of the major risk factors of cerebral atherosclerotic disease, however, its level of contribution to extracranial and intracranial atherosclerotic stenosis (ECAS and ICAS) was not fully revealed yet. The purpose of our study was to assess the association of CS to cerebral atherosclerosis along with other risk factors.
Materials and Methods: All consecutive patients who were angiographically confirmed with severe symptomatic cerebral atherosclerotic disease between January 2002 and December 2012 were included in this study. Multivariate logistic regression analyses were performed to identify risk factors for ECAS and ICAS. Thereafter, CS group were compared to non-CS group in the entire study population and in a propensity-score matched population with two different age-subgroups.
Results: Of 1709 enrolled patients, 794 (46.5%) had extracranial (EC) lesions and the other 915 (53.5%) had intracranial (IC) lesions. CS group had more EC lesions (55.8% vs. 35.3%, P<0.001) whereas young age group (<50 years) had more IC lesion (84.5% vs. 47.6%, P<0.001). In multivariate analysis, seven variables including CS, male, old age, coronary heart disease, higher erythrocyte sedimentation rate, multiple lesions, and anterior lesion were independently associated with ECAS. In the propensity-score matched CS group had significant more EC lesion compared to non-CS group (65.7% vs. 47.9%) only in the old age subgroup.
Conclusion: In contrast to a significant association between CS and severe symptomatic ECAS shown in old population, young patients did not show this association and showed relatively higher preference of ICAS.
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KEYWORD
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Atherosclerosis, Risk factors, Cerebrovascular circulation, Smoking
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