Silent brain infarction is associated with carotid siphon calcification in ischemic stroke patients

Li, Jingjing; Fan, Yuhua; Zhang, Jian; Xing, Shihui; Tang, Shujin; Li, Xiaoshuang; Dang, Chao; Zeng, Jinsheng

doi:10.1016/j.nicl.2022.103050

Cited by 3 publications

(1 citation statement)

References 39 publications

(49 reference statements)

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“…Furthermore, other traditional CVRFs, such as DM and smoking, are also important links between CF-PWV and ICAC [35,36]. It is known that smoking is associated with the dominant intimal and diabetes with the dominant medial ICAC subtype [37].…”

Section: Discussionmentioning

confidence: 99%

Aortic Stiffness Is Independently Associated with Intracranial Carotid Artery Calcification in Patients with Ischemic Stroke

Gozdalski,

Nowicki,

Kwarciany

et al. 2023

Cerebrovasc Dis

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Introduction: Intracranial carotid artery calcification (ICAC), as a strong contributor to the occurrence of ischemic stroke, might be present in the medial or intimal arterial layer. Traditional cardiovascular risk factors (CVRFs) are associated with ICAC; however, its association with new markers of vascular function is less understood. The paper aimed to evaluate the relationship between carotid-femoral pulse wave velocity (CF-PWV) and ICAC subtypes. Methods: We enrolled 65 patients with ischemic stroke. CF-PWV, systolic, diastolic, mean blood pressure, and pulse pressure were measured within 6 ± 2 days after stroke onset, and CT was performed within 24 h. ICAC on the stroke site was classified by two methods: volume and score based. Tertiles of ICAC volume were determined, and low-grade ICAC (T1) was regarded as a reference. According to the score-based method, (dominant) medial and (dominant) intimal ICAC subtypes were determined. Data were analyzed with multivariate logistic regression. Results: Medial and intimal ICAC subtypes were found in 34 (52%) and 24 (37%) patients, respectively. In 11% of patients, no ICAC calcifications were found. CF-PWV was higher in patients with high-grade ICAC (OR = 1.56, 95% CI = 1.03–2.35, p = 0.035). CF-PWV was higher in patients with the medial ICAC subtype (OR = 1.60, 95% CI = 1.00–2.55, p = 0.049) after adjustment for traditional CVRFs. Conclusion: Our study demonstrates that among patients with ischemic stroke, aortic stiffness is independently associated with ICAC and that medial ICAC, compared with intimal ICAC, is accompanied by more advanced aortic stiffness.

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Section: Discussionmentioning

confidence: 99%

Aortic Stiffness Is Independently Associated with Intracranial Carotid Artery Calcification in Patients with Ischemic Stroke

Gozdalski,

Nowicki,

Kwarciany

et al. 2023

Cerebrovasc Dis

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Intimal predominant calcification is associated with plaque instability in the vertebrobasilar artery by vessel wall magnetic resonance imaging and computed tomography

Song,

Liu,

Xue

et al. 2023

European Journal of Radiology

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Impact of Carotid Siphon Calcification on the Course and Outcome of Patients With Aneurysmal Subarachnoid Hemorrhage

Engel,

Song,

Rauschenbach

et al. 2024

Stroke

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BACKGROUND: Carotid siphon calcification (CSC) serves as a marker of atherosclerosis and therefore may influence the outcome after subarachnoid hemorrhage (aSAH). We aimed to analyze the impact of CSC on neurological outcomes, ischemia, and vasospasm. METHODS: A total of 716 patients with aSAH were treated between December 2004 and June 2016 in our central European tertiary neurovascular care center in Essen, Germany. CSC was recorded using the Woodcock scale (grades 0–3) on a computed tomography scan. Study end points included an unfavorable outcome at 6 months post-aSAH (modified Rankin Scale score ≥4), vasospasm, and early cerebral ischemia (72 hours) and delayed cerebral ischemia (delayed cerebral ischemia; >72 hours) in the follow-up computed tomography scans. The associations were adjusted for patients’ baseline characteristics and secondary complications. Finally, within a subgroup analysis, patients with and without daily aspirin intake after endovascular aneurysm occlusion were compared. RESULTS: Increasing grades of CSC were associated with lower rates of vasospasm in the anterior circulation. Severe CSC (grade 3) was independently related to the risk of an unfavorable outcome (adjusted odds ratio [aOR], 4.06 [95% CI, 1.98–8.33]; P <0.001) and early cerebral ischemia (aOR, 1.58 [95% CI, 1.03–2.43]; P =0.035) but not delayed cerebral ischemia (aOR, 1.08 [95% CI, 0.67–1.73]; P =0.763). In the aspirin subgroup analysis, the negative effect of severe CSC on functional outcome remained significant only in aSAH cases without aspirin (aOR, 5.47 [95% CI, 2.38–12.54]; P <0.001). In contrast, there was no association between severe CSC and unfavorable outcomes among individuals with daily aspirin intake (aOR, 0.84 [95% CI, 0.59–4.21]; P =0.603). CONCLUSIONS: Our data suggest CSC as a cerebrovascular risk factor resulting in higher rates of early cerebral ischemia and unfavorable outcomes after aSAH. However, by increasing arterial stiffness, CSC might lower the probability of vasospasm, which could explain the missing link between CSC and delayed cerebral ischemia. Additionally, aspirin intake seems to potentially mitigate the negative impact of CSC on aSAH outcome. Further investigations are needed to confirm the observations from the present study.

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Silent brain infarction is associated with carotid siphon calcification in ischemic stroke patients

Cited by 3 publications

References 39 publications

Aortic Stiffness Is Independently Associated with Intracranial Carotid Artery Calcification in Patients with Ischemic Stroke

Aortic Stiffness Is Independently Associated with Intracranial Carotid Artery Calcification in Patients with Ischemic Stroke

Intimal predominant calcification is associated with plaque instability in the vertebrobasilar artery by vessel wall magnetic resonance imaging and computed tomography

Impact of Carotid Siphon Calcification on the Course and Outcome of Patients With Aneurysmal Subarachnoid Hemorrhage

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