FOLLOW-UP VESSEL WALL MR IMAGING TO EXPLORE SEX-DIFFERENCES OF INTRACRANIAL ARTERIAL WALL CHANGES AND INTRACRANIAL ATHEROSCLEROTIC PLAQUE TREATMENT EFFICACY

Mortality related to cardiovascular disease in the US is improving. Yet the rate of decline is less for women than for men. Women's health is unique due to the varying reproductive stages, and differences are further heightened by sex-specific molecular and cellular characteristics of the heart and vasculature. These biophysiological distinctions may help explain sex disparities in risk factor burden and outcomes after a stroke. While women have some unique risk factors, the predominant risk factors for stroke, such as hypertension and hyperlipidemia, are similar between the sexes. However, the frequency of each risk factor varies resulting in differing population attributable risks. Effective screening and early management of these modifiable risk factors will have the greatest impact to stroke prevention. The same risk factors for cardiovascular disease also underlie the development of intracranial atherosclerotic disease (ICAD), a leading cause of stroke. Yet surprisingly, the development and progression of ICAD has not been explored in women despite the intimate association with stroke. High-resolution vessel wall MR imaging (VWI) permits visualization of vessel wall changes and may potentially serve as a noninvasive screening test for populations of women for early ICAD detection. We propose a study to prospectively evaluate women and men with stroke using VWI to estimate the prevalence of vessel wall abnormalities leading to stroke. Early detection of vessel wall changes in correlation with modifiable risk factors will help us identify opportunities for early prevention of stroke in women. Additionally, longitudinal imaging data and statin non-adherence questionnaires will provide data to evaluate the efficiency of stroke treatment post intervention and identify reasons for non-adherence.