title: Echoing Plaque Activity of the Coronary and Intracranial Arteries in Patients With Stroke.
abstract: Atherosclerosis is a systemic disease, and both coronary and intracranial atherosclerosis are common in the elderly. Unlike coronary artery disease (CAD), intracranial atherosclerotic disease can cause intracranial atherosclerotic stroke by branch occlusive disease (B-type) and coronary-type rupture of plaque (C-type). We hypothesized that plaque characteristics of intracranial arteries are associated with those of coronary arteries.
  
  
  
  Eighty-one patients with acute cerebral infarcts caused by intracranial atherosclerotic disease without history of CAD were analyzed. Asymptomatic CAD burden (number and degree of stenosis) and plaque characteristics (calcified, mixed, and noncalcified) were measured with multidetector computed tomography, whereas the asymptomatic intracranial atherosclerotic disease burden was measured using magnetic resonance angiography. The symptomatic intracranial artery was analyzed using high-resolution magnetic resonance imaging for vascular morphology (stenosis degree, remodeling index, and wall index) and plaque activation (enhancement pattern and volume).
  
  
  
  The asymptomatic CAD burden was correlated with the asymptomatic intracranial atherosclerotic disease burden. The overall CAD burden did not differ between B- and C-type intracranial atherosclerotic stroke. However, the prevalence of noncalcified coronary plaque was much higher in C-type intracranial atherosclerotic stroke and the presence of coronary noncalcified plaque was independently associated with C-type intracranial atherosclerotic stroke (odds ratio, 3.38; 95% confidence interval, 1.05-10.85; P=0.041). As the number of coronary noncalcified plaques increased, positive remodeling and plaque enhancement increased in the symptomatic intracranial artery on high-resolution magnetic resonance imaging.
  
  
  
  Plaques within the intracranial and coronary arteries behave in similar ways. Our results suggest the need to evaluate and treat other vascular trees in patients with vulnerable plaques within a single arterial system.
authors.affiliation: From the Departments of Neurology (J.-W.C., O.Y.B., M.J.L., J.H.) and Radiology (J.C., Y.H.C.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; and Department of Medicine, Cardiovascular Imaging Center, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-H.C.).
authors.forename: Jong-Won
authors.initials: JW
authors.lastname: Chung
authors.affiliation: From the Departments of Neurology (J.-W.C., O.Y.B., M.J.L., J.H.) and Radiology (J.C., Y.H.C.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; and Department of Medicine, Cardiovascular Imaging Center, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-H.C.). ohyoung.bang@samsung.com.
authors.forename: Oh Young
authors.initials: OY
authors.lastname: Bang
authors.affiliation: From the Departments of Neurology (J.-W.C., O.Y.B., M.J.L., J.H.) and Radiology (J.C., Y.H.C.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; and Department of Medicine, Cardiovascular Imaging Center, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-H.C.).
authors.forename: Mi Ji
authors.initials: MJ
authors.lastname: Lee
authors.affiliation: From the Departments of Neurology (J.-W.C., O.Y.B., M.J.L., J.H.) and Radiology (J.C., Y.H.C.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; and Department of Medicine, Cardiovascular Imaging Center, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-H.C.).
authors.forename: Jaechun
authors.initials: J
authors.lastname: Hwang
authors.affiliation: From the Departments of Neurology (J.-W.C., O.Y.B., M.J.L., J.H.) and Radiology (J.C., Y.H.C.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; and Department of Medicine, Cardiovascular Imaging Center, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-H.C.).
authors.forename: Jihoon
authors.initials: J
authors.lastname: Cha
authors.affiliation: From the Departments of Neurology (J.-W.C., O.Y.B., M.J.L., J.H.) and Radiology (J.C., Y.H.C.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; and Department of Medicine, Cardiovascular Imaging Center, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-H.C.).
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Choi
authors.affiliation: From the Departments of Neurology (J.-W.C., O.Y.B., M.J.L., J.H.) and Radiology (J.C., Y.H.C.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; and Department of Medicine, Cardiovascular Imaging Center, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (J.-H.C.).
authors.forename: Yeon Hyeon
authors.initials: YH
authors.lastname: Choe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000000981:diagnostic imaging; D002536:Cerebral Arteries / Q000000981:diagnostic imaging*; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000000981:diagnostic imaging*; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging* / Q000209:etiology
keywords: atherosclerosis; cerebral infarction; coronary artery disease; magnetic resonance imaging; stroke