{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T22:43:47Z","timestamp":1789425827972,"version":"build-2803163510"},"reference-count":53,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,10,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Cerebral amyloid angiopathy (CAA) is a heterogeneous small vessel disease that can occur independently or alongside Alzheimer disease (AD). CAA is diagnosed using the Boston Criteria 2.0, integrating clinical and neuroimaging features, whereas the Cerebrospinal Fluid (CSF) role in clinical practice remains under investigation. This study explores whether CSF biomarkers can identify distinct disease phenotypes, supporting hemorrhagic risk stratification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We enrolled probable patients with CAA retrospectively (Boston Criteria 2.0) from 2 institutions, collecting clinical, neuroimaging, and follow\u2010up data alongside core CSF biomarkers (A\u03b240 [amyloid \u03b2 1\u201340], A\u03b242 [amyloid \u03b2 1\u201342], p\u2010Tau181 [phosphorylated Tau], total\u2010Tau). Patients with CAA were stratified applying the Amyloid Tau Neurodegeneration (ATN) research framework, according to the presence of CSF amyloidosis (A\n                      <jats:sup>+<\/jats:sup>\n                      CAA versus A\n                      <jats:sup>\u2212<\/jats:sup>\n                      CAA) and tauopathy (A\n                      <jats:sup>+<\/jats:sup>\n                      T\n                      <jats:sup>+<\/jats:sup>\n                      CAA versus A\n                      <jats:sup>+<\/jats:sup>\n                      T\n                      <jats:sup>\u2212<\/jats:sup>\n                      CAA), and using unsupervised clustering, which defined CAA subgroups based on CSF biomarker levels only. Kaplan\u2010Meier and Cox regression analyses assessed the predictive value of CSF\u2010based subgroups for symptomatic hemorrhages during follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Seventy\u2010one probable CAA patients (aged 71.77\u00b18.45\u2009years, 66% men, median follow\u2010up 1.15\u2009years [0.50\u20132.44]) were enrolled. A\n                      <jats:sup>+<\/jats:sup>\n                      CAA showed a higher prevalence of cortical superficial siderosis than A\n                      <jats:sup>\u2212<\/jats:sup>\n                      CAA (67% versus 25%,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.016). A\n                      <jats:sup>+<\/jats:sup>\n                      T\n                      <jats:sup>\u2212<\/jats:sup>\n                      CAA had a greater hemorrhagic risk than A\n                      <jats:sup>+<\/jats:sup>\n                      T\n                      <jats:sup>+<\/jats:sup>\n                      CAA during follow\u2010up (29 versus 7 events per 100 patient\u2010years,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.010; log\u2010rank test:\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.013). Unsupervised clustering identified 2 subgroups, which we defined as pure CAA and CAA\u2010ADA, with pure CAA presenting more symptomatic hemorrhages during follow\u2010up (22 versus 0 events per 100 patient\u2010years,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.017; log\u2010rank test,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.011).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">CSF\u2010based profiling effectively stratifies CAA phenotypes, offering a promising prognostic tool alongside neuroimaging markers. Further validation is needed to confirm its role in identifying patients with CAA with different natural histories.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.044784","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T12:28:33Z","timestamp":1760444913000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Cerebrospinal Fluid Biomarkers Profiling in Cerebral Amyloid Angiopathy and Relationship With Disease Phenotypes"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2942-1307","authenticated-orcid":false,"given":"Mattia","family":"Losa","sequence":"first","affiliation":[{"name":"University of Genoa","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3090-9648","authenticated-orcid":false,"given":"Matteo Cotta","family":"Ramusino","sequence":"additional","affiliation":[{"name":"IRCCS Mondino Foundation","place":["Pavia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2096-4793","authenticated-orcid":false,"given":"Isabella","family":"Cama","sequence":"additional","affiliation":[{"name":"University of Genoa","place":["Italy"]},{"name":"University of Genoa","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8511-1022","authenticated-orcid":false,"given":"Lorenzo","family":"Gualco","sequence":"additional","affiliation":[{"name":"University of Genoa","place":["Italy"]},{"name":"Azienda Ospedaliero\u2010Universitaria Santi Antonio e Biagio e Cesare Arrigo","place":["Alessandria, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Gandoglia","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Policlinico San Martino","place":["Genoa, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5667-204X","authenticated-orcid":false,"given":"Federico","family":"Massa","sequence":"additional","affiliation":[{"name":"University of Genoa","place":["Italy"]},{"name":"IRCCS Ospedale Policlinico San Martino","place":["Genoa, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9353-8314","authenticated-orcid":false,"given":"Andrea","family":"Donniaquio","sequence":"additional","affiliation":[{"name":"E.O. 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