Risk factors for calcification of the vertebrobasilar arteries in cardiovascular patients referred for a head CT, the SMART study

Beukel, Tim C. van den; Lucci, Carlo; Hendrikse, Jeroen; Spiering, Wilko; Koek, Huiberdina L.; Geerlings, Mirjam I.; Jong, Pim A. de

doi:10.1016/j.neurad.2020.02.004

Cited by 5 publications

(4 citation statements)

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“…Apart from precipitated calcium deposits in necrotic tissue, calcifications may have “bone-like” structures driven by hematopoietic cells ( 20 ), thereby appearing as high densities on CT scans along the artery. Furthermore, previous studies have suggested VBAC as associated with intracranial atherosclerosis ( 13 , 14 ).…”

Section: Discussionmentioning

confidence: 96%

“…At present, there is no imaging method to quickly determine the type of occlusion (8, b). Vertebrobasilar artery calcification (VBAC) on non-contrast computed tomography (NCCT) is widely used to visualize and represent intracranial atherosclerosis ( 13 , 14 ). Therefore, this study was designed to investigate the relationship between VBAC and ICAS-O in order to potentially quickly determine the types of occlusions.…”

Section: Introductionmentioning

confidence: 99%

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The relationship between vertebrobasilar artery calcification and intracranial atherosclerosis-related occlusion in thrombectomy

et al. 2022

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Background and purposeDistinguishing between intracranial atherosclerosis-related occlusion (ICAS-O) and non-ICAS-O can benefit strategies of identifying the need for surgical plans prior to thrombectomy. We investigated the association between vertebrobasilar artery calcification (VBAC) and ICAS-O in acute ischemic stroke patients undergoing thrombectomy.MethodsPatients were recruited from a prospective single-center registration study who had undergone thrombectomy between October 2017 and October 2021. The enrolled patients were divided into ICAS-O and non-ICAS-O, as determined by the intraarterial therapy process. The occurrences of VBAC were recorded on intracranial non-contrast computed tomography (NCCT) scans before thrombectomy. The association between VBAC and ICAS-O was assessed using binary logistic regression.ResultsA total of 2732 patients who had undergone digital subtraction angiography were reviewed, and 314 thrombectomy patients (mean age: 65.4 years, 36.6% female) with NCCT were enrolled in this study. VBAC was detected before thrombectomy in 113 (36%) out of 314 patients. Age, hypertension, and diabetes were associated with VBAC, and a higher frequency of VBAC was identified in patients presenting posterior circulation. ICAS-O accounts for 43% (135/314) in eligible patients. From multivariable analyses, VBAC was identified as an independent predictor of ICAS-O (adjusted odds ratio, 6.16 [95% CI, 2.673–14.217], P < 0.001). Meanwhile, the (VBAC[+] atrial fibrillation[-]) group displayed higher rates of ICAS-O than the (VBAC[-] atrial fibrillation [-]) group (P < 0.001).ConclusionsWe demonstrated that VBAC is an independent risk factor for ICAS-O in patients who underwent thrombectomy. Patients free of atrial fibrillation with VBAC have more trend to be ICAS-O.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

The relationship between vertebrobasilar artery calcification and intracranial atherosclerosis-related occlusion in thrombectomy

et al. 2022

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“…Third, we evaluated the intracranial internal carotid arteries as proxy for arteriosclerosis of the anterior circulation, but posterior arteriosclerosis is also often observed. 36,37 The prevalence and distribution of intracranial carotid arteriosclerosis differs from that of posterior intracranial arteries. 4,38 However, as the CT classification method that we used is not histologically validated to determine posterior arteriosclerotic subtypes on CT, posterior arteries were not addressed in our study.…”

Section: Discussionmentioning

confidence: 99%

Morphological Subtypes of Intracranial Internal Carotid Artery Arteriosclerosis and the Risk of Stroke

Beukel

Toorn

Vernooij

et al. 2022

Stroke

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Background and Purpose: Accumulating evidence highlights the existence of distinct morphological subtypes of intracranial carotid arteriosclerosis. So far, little is known on the prevalence of these subtypes and subsequent stroke risk in the general population. We determined the prevalence of morphological subtypes of intracranial arteriosclerosis and assessed the risk of stroke associated with these subtypes. Methods: Between 2003 and 2006, 2391 stroke-free participants (mean age 69.6, 51.7% women) from the population-based Rotterdam Study underwent noncontrast computed tomography to visualize calcification in the intracranial carotid arteries as a proxy for intracranial arteriosclerosis. Calcification morphology was evaluated according to a validated grading scale and categorized into intimal, internal elastic lamina (IEL), or mixed subtype. Follow-up for stroke was complete until January 1, 2016. We used multivariable Cox regression to assess associations of each subtype with incident stroke. Results: The prevalence of calcification was 82% of which 39% had the intimal subtype, 48% IEL subtype, and 13% a mixed subtype. During a median follow-up of 10.4 years, 155 participants had a stroke. All 3 subtypes were associated with a higher risk of stroke (adjusted hazard ratio [95% CI] for intimal: 2.11 [1.07–4.13], IEL: 2.66 [1.39–5.11], and mixed subtype 2.57 [1.18–5.61]). The association of the IEL subtype with stroke was strongest among older participants. The association of the intimal subtype with stroke was noticeably stronger in women than in men. Conclusions: Calcification of the IEL was the most prevalent subtype of intracranial arteriosclerosis. All 3 subtypes were associated with an increased risk of stroke, with noticeable age and sex-specific differences.

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“… 3 22 The traditional risk predictors associated with stroke include dyslipidemia, old age, male gender, smoking status, obesity/high fat diet, and arterial calcification of vessels supplying the central nervous system. 9 10 23 Hypercholesterolemia and hypertriglyceridemia are associated with vascular diseases and elevated stroke incidence, whereas HDL and LDL have displayed limited association with vascular diseases and resultant cerebral diseases outcomes. 10 24 In the current study, although initial analysis demonstrated that cholesterol levels had association with stroke ( p = 0.04) and there was significant difference in controls related to CVA cases ( p = 0.035), yet the regression analysis failed to maintain this significance.…”

Section: Discussionmentioning

confidence: 99%

The Connotation of Variances in the Risk Predictors, Medications, Homocysteine, and Homocysteine Pathway Gene Polymorphisms with CVA/Stroke

Rizwan¹,

Khan²,

Anjum³

et al. 2020

Global Medical Genetics

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Cerebrovascular accidents (CVAs) are vascular multifactorial, multigenic ailments with intricate genetic, environmental risk influences. The present study aimed to establish affiliation of CVAs/stroke with blood parameters, differences in prescribed drugs consumption, and with differences in homocysteine pathway genes polymorphisms. The participants in study included controls n = 251, transient ischemic attack (TIA) patients n = 16, and stroke cases n = 122, respectively, (total participants, n = 389). The analyzed single nucleotide polymorphisms (SNPs) included C677T(rs1801133), A1298C(rs1801131) of methylene tetrahydrofolate reductase (MTHFR), A2756G(rs1805087) of methyl tetrahydrofolate homocysteine methyltransferase/methionine synthase (MS), and the A192G(rs662) of paraoxonase 1(PON1) genes, all validated by tetra-primer allele refractory mutation system polymerase chain reaction (T-ARMS-PCR). The insertion deletion (I/D; rs4646994) polymorphism in angiotensin converting enzyme (ACE) gene was analyzed using routine PCR. All studied traits were scrutinized through analysis of variance (ANOVA), and later through regression analysis. Through ANOVA and multiple comparison, there was association of CVA with serum homocysteine, cholesterol, and with diastolic blood pressure readings. When data was subjected to regression, serum homocysteine and diastolic blood pressure (significant through ANOVA), as well as two additional traits, high-density lipoproteins (HDL), and rs1801133 MTHFR SNP sustained statistical significance and noteworthy odds in relation to CVA and stroke. The ailments affecting cerebral vasculature are mutifactorial, whereby genes, proteins, and environmental cues all exert cumulative effects enhancing CVA risk. The current study emphasizes that SNPs and variation in circulating biomarkers can be used for screening purposes and for reviewing their effects in stroke/CVA-linked risk progression.

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Risk factors for calcification of the vertebrobasilar arteries in cardiovascular patients referred for a head CT, the SMART study

Cited by 5 publications

References 46 publications

The relationship between vertebrobasilar artery calcification and intracranial atherosclerosis-related occlusion in thrombectomy

The relationship between vertebrobasilar artery calcification and intracranial atherosclerosis-related occlusion in thrombectomy

Morphological Subtypes of Intracranial Internal Carotid Artery Arteriosclerosis and the Risk of Stroke

The Connotation of Variances in the Risk Predictors, Medications, Homocysteine, and Homocysteine Pathway Gene Polymorphisms with CVA/Stroke

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