Cervicocephalic Spotty Calcium for the Prediction of Coronary Atherosclerosis in Patients With Acute Ischemic Stroke

Zheng, Chuansheng; Yan, Shaozhen; Fan, Feifei; Zhao, Cheng; Guo, Daode; Wang, Zhichao; Lu, Jie

doi:10.3389/fneur.2021.659156

Cited by 8 publications

(8 citation statements)

References 28 publications

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“…In our study, 44.4% of the patients were Black. Our results are in line with those of prior studies that investigated rates of subclinical CAD in patients from countries with predominantly White or Asian populations and IS caused by diverse etiologies ( 40 , 41 ), non-cardioembolic stroke ( 12 , 13 ), or atherosclerosis ( 24 ).…”

Section: Discussionsupporting

confidence: 92%

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Ischemic stroke caused by large-artery atherosclerosis: a red flag for subclinical coronary artery disease

et al. 2023

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BackgroundThe coronary calcium score (CAC) measured on chest computerized tomography is a risk marker of cardiac events and mortality. We compared CAC scores in two multiethnic groups without symptomatic coronary artery disease: subjects in the chronic phase after stroke or transient ischemic attack and at least one symptomatic stenosis ≥50% in the carotid or vertebrobasilar territories (Groupathero) and a control group (Groupcontrol).MethodsIn this cross-sectional study, Groupathero included two subgroups: GroupExtraorIntra, with stenoses in either cervical or intracranial arteries, and GroupExtra&Intra, with stenoses in at least one cervical and one intracranial artery. Groupcontrol had no history of prior stroke/transient ischemic attacks and no stenoses ≥50% in cervical or intracranial arteries. Age and sex were comparable in all groups. Frequencies of CAC ≥100 and CAC > 0 were compared between Groupathero and Groupcontrol, as well as between GroupExtraorIntr, GroupExtra&Intra, and Groupcontrol, with bivariate logistic regressions. Multivariate analyses were also performed.ResultsA total of 120 patients were included: 80 in Groupathero and 40 in Groupcontrol. CAC >0 was significantly more frequent in Groupathero (85%) than Groupcontrol (OR, 4.19; 1.74–10.07; p = 0.001). Rates of CAC ≥100 were not significantly different between Groupathero and Groupcontrol but were significantly greater in GroupExtra&Intra (n = 13) when compared to Groupcontrol (OR 4.67; 1.21–18.04; p = 0.025). In multivariate-adjusted analyses, “Groupathero” and “GroupExtra&Intra” were significantly associated with CAC.ConclusionThe frequency of coronary calcification was higher in subjects with stroke caused by large-artery atherosclerosis than in controls.

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Section: Discussionsupporting

confidence: 92%

“…Severe CAD was also associated with the presence of stenoses due to atherosclerosis in cervicocephalic arteries ( 23 ). In Chinese patients, CAC scores were significantly higher in patients with acute IS caused by atherosclerosis than in a control group composed of subjects with asymptomatic carotid atherosclerosis ( 24 ).…”

Section: Introductionmentioning

confidence: 95%

Ischemic stroke caused by large-artery atherosclerosis: a red flag for subclinical coronary artery disease

et al. 2023

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“…29 Although spotty calcium detected via coronary CTA has been reported to be an important prognostic factor for ACS, 30 the association of spotty calcium in carotid CTA with MACEs has been rarely investigated. 31 Spotty calcium is likely to exist in lipid-rich plaques and be associated with inflammatory processes and vulnerability, unlike large calcifications in fibrocalcific plaques. 13,32 Hounsfield unit values are known to reflect plaque composition; lower Hounsfield unit values are associated with higher probabilities of unstable plaques with large lipid cores and intraplaque hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Carotid Plaque Composition Assessed by CT Predicts Subsequent Cardiovascular Events among Subjects with Carotid Stenosis

Choi¹,

Byun²,

Kwon³

et al. 2021

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Currently, the characteristics of carotid plaques are considered important factors for identifying subjects at high risk of stroke. This study aimed to test the hypothesis that carotid plaque composition assessed by CTA is associated with an increased risk of future major adverse cardiovascular events among asymptomatic subjects with moderate-to-severe carotid artery stenosis. MATERIALS AND METHODS:This single-center, retrospective cohort study included 194 carotid plaques from 176 asymptomatic subjects with moderate-to-severe carotid artery stenosis. The association of CTA-determined plaque composition with the risk of subsequent adverse cardiovascular events was analyzed.RESULTS: During a median follow-up of 41 months, the adverse cardiovascular event incidence among 194 carotid plaques was 19.6%. There were significant differences in plaque Hounsfield units (P , .001) and spotty calcium presence (P , .001) between carotid plaques from subjects with and without subsequent adverse cardiovascular events. Multivariable analysis revealed carotid plaque Hounsfield unit density (P , .001) and spotty calcium (P , .001) as independent predictors of subsequent adverse cardiovascular events. In association with moderate carotid artery stenosis, the plaque Hounsfield unit values were significantly lower among carotid plaques from subjects who experienced subsequent adverse cardiovascular events (P ¼ .002), strokes (P ¼ .01), and cardiovascular deaths (P ¼ .04); the presence of spotty calcium was significantly associated with the occurrence of adverse cardiovascular events (P ¼ .001), acute coronary syndrome (P ¼ .01), and cardiovascular death (P ¼ .04).CONCLUSIONS: Carotid plaque Hounsfield unit density and spotty calcium were independent predictors of a greater risk of adverse cardiovascular event occurrence. ABBREVIATIONS: ACS ¼ acute coronary syndrome; CAS ¼ carotid artery stenosis; DUS ¼ Doppler ultrasound; HR ¼ hazard ratio; IQR ¼ interquartile range; MACE ¼ major adverse cardiovascular event

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“…The CAD risk associated with vascular involvement over two years is 50% higher in AIS individuals without coronary atherosclerosis. The chance of CAD combined with a vascular disease don't have cardiac symptoms is 4.36 times higher [4,5]. Arterial calci cation is a common nding in computed tomography angiography (CTA) patients with AIS.…”

Section: Introductionmentioning

confidence: 99%

“…The ability of CAC scoring, a well-known technique, to categorize the chance of mortality from cardiovascular disease is exceedingly crucial. The best instrument for risk discrimination has continuously been demonstrated to be CAC in several sizable international registries [4]. Studies have connected coronary artery calcium (CAC) to increased heart attacks.…”

Section: Introductionmentioning

confidence: 99%

Relationships between Left circumflex artery (LCX) and Left anterior descending (LAD) involvements and calcification in patients with Coronary heart disease(CHD): a cross-sectional study

Hassani¹,

Azami

Asadi

et al. 2022

Preprint

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Background This study aimed to investigate the relationships between LM, LAD, and LCX lesions and calcification in patients referred to Imam Khomeini Hospital, Medical, and Research center (Tehran, Iran). Methods The present study was an applied, cross-sectional, and observational study conducted on hospitalized patients suffering from coronary heart disease (CHD). By non-random sampling, 50 CHD patients who met the inclusion criteria were selected. CT angiography and MRI results were investigated, and field data collected by checklists were analyzed in IBM SPSS Statistics v. 13.00. Results There was no relationship between LM involvement and calcification, with 80% sensitivity and 44% specificity in the diagnosis of LM involvement. By contrast, LAD involvement was significantly correlated with calcification, with 77.8% sensitivity and 83.3% specificity in diagnosing LAD involvement. Likewise, a significant association was observed between LCX involvement and calcification, with corresponding LCX involvement diagnosis sensitivity and specificity values of 72.2% and 91.7%, respectively. Conclusion There was a significant correlation between LAD/LCX and calcification; However, there was no meaningful connection between LM and calcification.

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Cervicocephalic Spotty Calcium for the Prediction of Coronary Atherosclerosis in Patients With Acute Ischemic Stroke

Cited by 8 publications

References 28 publications

Ischemic stroke caused by large-artery atherosclerosis: a red flag for subclinical coronary artery disease

Ischemic stroke caused by large-artery atherosclerosis: a red flag for subclinical coronary artery disease

Carotid Plaque Composition Assessed by CT Predicts Subsequent Cardiovascular Events among Subjects with Carotid Stenosis

Relationships between Left circumflex artery (LCX) and Left anterior descending (LAD) involvements and calcification in patients with Coronary heart disease(CHD): a cross-sectional study

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