机构：[1]Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases,Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing.[2]Department of Radiology,Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing.[3]Central Research Laboratory,Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing.[4]Department of Neurology, Jining No. 1 People’s Hospital, China[5]Department of Neurology, Tangshan Gongren Hospital, China[6]Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China[7]Department of Neurology, Tongren Hospital, Shanghai Jiaotong University School of Medicine, China[8]Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China[9]Department of Neurology, China-Japan Union Hospital, Jilin University, Changchun吉林大学中日联谊医院[10]Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China[11]Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, China首都医科大学附属安贞医院[12]Department of Neurology, West China Hospital, Sichuan University, Chengdu四川大学华西医院[13]Department of Neurology, Hebei General Hospital, Shijiazhuang, China[14]Department of Neurology, Beijing Hospital, National Center of Gerontology, China[15]Department of Neurology, People’s Hospital Ningxia Hui Autonomous Region, Yinchuan, China
Little is known about the dynamic process of the outer-wall boundary during intensive lipid-lowering therapy in patients with intracranial atherosclerotic stenosis and its clinical implications.We analyzed patients with first-ever acute ischemic stroke attributed to intracranial atherosclerotic stenosis who received intensive lipid-lowering therapy with high-dose statins and PCSK9i (proprotein convertase subtilisin/kexin type 9 inhibitor). Data were obtained from a multicenter cohort study at 15 hospitals across China and our institutional database in Beijing, China. All patients underwent 3-dimensional T1-weighted high-resolution magnetic resonance vessel wall imaging at baseline and after a >6-month follow-up period. Outer-wall boundary area changes were classified as expansion (>10% increase), shrinkage (>10% decrease), or quiescence (≤10% change). The association between these changes and time to recurrent ipsilateral stroke was assessed. The Kaplan-Meier method and the Cox proportional hazards model were used.Among the 137 patients, 50 (36.5%) exhibited expansion, 40 (29.2%) shrinkage, and 47 (34.3%) quiescence of the outer-wall boundary area. Among these 3 groups, plaque burden decreased significantly between the index imaging and follow-up (all P≤0.02). Lumen area increased significantly in patients with expansion (P<0.001) and quiescence (P=0.01) but not in those with shrinkage of the outer-wall boundary area (P=0.34). Patients with shrinkage of the outer-wall boundary area had a significantly increased risk of recurrent ipsilateral stroke (hazard ratio, 2.95 [95% CI, 1.02-8.55]; P=0.046) compared with patients without such shrinkage. In multivariable Cox regression analysis, shrinkage of the outer-wall boundary area was associated with recurrent ipsilateral stroke compared with nonshrinkage after adjusting for potential confounders (hazard ratio, 4.21 [95% CI, 1.14-15.58]; P=0.031).Outer-wall boundary area changes vary among patients with intracranial atherosclerotic stenosis under intensive lipid-lowering therapy. Shrinkage of the outer-wall boundary area is significantly associated with a higher risk of stroke recurrence.
基金：
This study was supported by the Noncommunicable Chronic Diseases-National Science and Technology Major Project (grant 2024ZD0521600), the National Science Fund for Distinguished Young Scholars (grant 82025013), the National High Level Hospital Clinical Research Funding (grants 2022-PUMCH-C-001 and 2022-PUMCH-D-007), the CAMS Innovation Fund for Medical Sciences (grant 2022-I2M-1-002), and the Ministry of Science and Technology of the People’s Republic of China (grants 2017YFC1307900 and 2017YFC1307902).
语种：
外文
PubmedID：
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出版当年[2025]版：
大类|1 区医学
小类|1 区临床神经病学1 区外周血管病
最新[2025]版：
大类|1 区医学
小类|1 区临床神经病学1 区外周血管病
第一作者：
第一作者机构：[1]Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases,Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing.
通讯作者：
推荐引用方式(GB/T 7714)：
Weizhuang Yuan,Zhongrui Yan,Baoquan Lu,et al.Vessel Shrinkage and Stroke Recurrence in Intracranial Atherosclerotic Stenosis Under Intensive Lipid-Lowering Therapy[J].Stroke.2025,doi:10.1161/STROKEAHA.125.051719.
APA：
Weizhuang Yuan,Zhongrui Yan,Baoquan Lu,Xiaoyun Liu,Ailian Du...&Wei-Hai Xu.(2025).Vessel Shrinkage and Stroke Recurrence in Intracranial Atherosclerotic Stenosis Under Intensive Lipid-Lowering Therapy.Stroke,,
MLA：
Weizhuang Yuan,et al."Vessel Shrinkage and Stroke Recurrence in Intracranial Atherosclerotic Stenosis Under Intensive Lipid-Lowering Therapy".Stroke .(2025)
医学