{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:05:03Z","timestamp":1790255103688,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2023YFC3503100"],"award-info":[{"award-number":["2023YFC3503100"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2023YFC3503103"],"award-info":[{"award-number":["2023YFC3503103"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stroke survivors are at increased risk of dementia, but clinically accessible markers of risk heterogeneity remain limited. Previous studies have largely examined atherosclerotic disease in individual vascular beds rather than the overall burden of systemic extracerebral atherosclerosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included UK Biobank participants without stroke at baseline who subsequently developed incident stroke and remained under follow\u2010up and dementia\u2010free 1\u2009year after the index event. Extracerebral atherosclerotic vascular disease (ECAVD) was evaluated according to its overall presence, the number of affected vascular beds, and the mutually adjusted contributions of carotid artery stenosis, coronary heart disease (CHD), and peripheral artery disease. Fine\u2013Gray subdistribution hazard models were used with death treated as a competing event. Missing covariate data were addressed using multiple imputation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 9571 participants, 584 developed all\u2010cause dementia during follow\u2010up. ECAVD was associated with a higher risk of dementia (subdistribution hazard ratio [sHR], 1.38; 95% confidence interval [CI] 1.13\u20131.68;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0014). The adjusted 5\u2010year risks were 4.4% and 3.2% in participants with and without ECAVD, respectively, and the corresponding 10\u2010year risks were 11.1% and 8.1%. Compared with no affected vascular beds, involvement of 1 vascular bed was associated with a higher dementia risk (sHR, 1.41; 95% CI 1.15\u20131.72), whereas the estimate for \u2265\u20092 affected beds was not statistically significant (sHR, 1.19; 95% CI 0.76\u20131.87). The per\u2010category trend was significant (sHR, 1.24; 95% CI 1.07\u20131.45). In mutually adjusted analyses, CHD was associated with dementia (sHR, 1.42; 95% CI 1.13\u20131.78), whereas peripheral artery disease and carotid artery stenosis were not. No significant interaction was observed by stroke subtype or dementia subtype. Lipid\u2010adjustment and complete\u2010case analyses yielded similar results.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ECAVD was associated with a higher risk of all\u2010cause dementia diagnosed more than 1\u2009year after incident stroke. ECAVD may provide a practical indicator of cumulative systemic vascular burden and long\u2010term cognitive risk, although vascular\u2010bed count findings should be interpreted cautiously.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70540","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:36:55Z","timestamp":1790253415000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Systemic Extracerebral Atherosclerotic Burden and Dementia Risk After Incident Stroke"],"prefix":"10.1002","author":[{"given":"Zhexuan","family":"Yu","sequence":"first","affiliation":[{"name":"School of Basic Medical Sciences Zhejiang Chinese Medical University  Hangzhou China"},{"name":"College of Chinese Medicine for Cardiovascular\u2010Cranial Disease Zhejiang Chinese Medical University  Hangzhou China"},{"name":"Zhejiang Key Laboratory of Chinese Medicine for Cardiovascular and Cerebrovascular Disease  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianxue","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Basic Medical Sciences Zhejiang Chinese Medical University  Hangzhou China"},{"name":"College of Chinese Medicine for Cardiovascular\u2010Cranial Disease Zhejiang Chinese Medical University  Hangzhou China"},{"name":"Zhejiang Key Laboratory of Chinese Medicine for Cardiovascular and Cerebrovascular Disease  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Jin","sequence":"additional","affiliation":[{"name":"School of Medical Technology and Information Engineering Zhejiang Chinese Medical University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weifeng","family":"Jin","sequence":"additional","affiliation":[{"name":"School of Pharmaceutical Sciences Zhejiang Chinese Medical University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5726-7214","authenticated-orcid":false,"given":"Haitong","family":"Wan","sequence":"additional","affiliation":[{"name":"School of Basic Medical Sciences Zhejiang Chinese Medical University  Hangzhou China"},{"name":"College of Chinese Medicine for Cardiovascular\u2010Cranial Disease Zhejiang Chinese Medical University  Hangzhou China"},{"name":"Zhejiang Key Laboratory of Chinese Medicine for Cardiovascular and Cerebrovascular Disease  Hangzhou 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