Jae Hyun Kim # 1, Hanwool Jeon # 1 2 3 4, Moinay Kim 1, Joonho Byun 5, Yeongu Chung 6, Si Un Lee 7, Wonhyoung Park 1, Jung Cheol Park 1, Jae Sung Ahn 1, Seungjoo Lee 8 9 10 11
Abstract
To investigate the association between chemical markers (triglyceride, C-reactive protein (CRP), and inflammation markers) and perfusion markers (relative cerebral vascular reserve (rCVR)) with moyamoya disease progression and complication types. A total of 314 patients diagnosed with moyamoya disease were included. Triglyceride and CRP levels were assessed and categorized based on Korean guidelines for dyslipidemia and CDC/AHA guidelines, respectively. Perfusion markers were evaluated using Diamox SPECT. Cox proportional hazard analysis was performed to examine the relationship between these markers and disease progression, as well as complication types (ischemic stroke, hemorrhagic stroke, and rCVR deterioration). Elevated triglyceride levels (≥ 200) were significantly associated with higher likelihood of end-point events (HR: 2.292, CI 1.00-4.979, P = 0.03). Severe decreased rCVR findings on Diamox SPECT were also significantly associated with end-point events (HR: 3.431, CI 1.254-9.389, P = 0.02). Increased CRP levels and white blood cell (WBC) count were significantly associated with moyamoya disease progression. For hemorrhagic stroke, higher triglyceride levels were significantly associated with end-point events (HR: 5.180, CI 1.355-19.801, P = 0.02). For ischemic stroke, severe decreased rCVR findings on Diamox SPECT (HR: 5.939, CI 1.616-21.829, P < 0.01) and increased CRP levels (HR: 1.465, CI 1.009-2.127, P = 0.05) were significantly associated with end-point events. Elevated triglyceride, CRP, and inflammation markers, as well as decreased rCVR, are potential predictors of moyamoya disease progression and complication types. Further research is warranted to understand their role in disease pathophysiology and treatment strategies.
Progression free survival depending on serum triglyceride level and relative cerebrovascular reserve (rCVR). This study aimed to investigate the relationship between chemical markers and the progression of moyamoya disease. The study found that patients with triglyceride levels of 200 or higher had a significantly higher likelihood of experiencing end-point events compared to those with triglyceride levels of less than 150 (HR: 2.292, CI 1.00–4.979, p = 0.03) (A). The Kaplan–Meier cumulative curves illustrate that patients with severe decreases in Diamox SPECT grade had a significantly higher likelihood of experiencing end-point events compared to those with normal grade SPECT (HR: 3.431, CI 1.254–9.389, p = 0.02) (B). For hemorrhagic stroke, the study found that patients with triglyceride levels of 200 or higher had a significantly higher likelihood of experiencing hemorrhagic stroke compared to those with triglyceride levels of less than 150 (HR: 5.180, CI 1.355–19.801, p = 0.02) (C). Patients with severely decreased rCVR as assessed by Diamox SPECT demonstrated a significantly higher risk of experiencing ischemic stroke events compared to those with normal SPECT findings (hazard ratio [HR]: 5.939, 95% confidence interval [CI]: 1.616–21.829, P < 0.01) (D).
서울아산병원 이승주교수님 연구실 202410 작성
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