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Ischemic stroke: measurement of intracranial artery calcifications can improve prediction of asymptomatic coronary artery disease

Authors
 Sung Soo Ahn  ;  Hyo Suk Nam  ;  Ji Hoe Heo  ;  Young Dae Kim  ;  Seung-Koo Lee  ;  Kyung Hwa Han  ;  Byoung Wook Choi  ;  Eung Yeop Kim 
Citation
 RADIOLOGY, Vol.268(3) : 842-849, 2013 
Journal Title
RADIOLOGY
ISSN
 0033-8419 
Issue Date
2013
MeSH
Aged ; Brain Ischemia/diagnostic imaging ; Brain Ischemia/epidemiology* ; Calcinosis/diagnostic imaging ; Calcinosis/epidemiology* ; Causality ; Comorbidity ; Coronary Angiography/statistics & numerical data ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/epidemiology* ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Prognosis ; Reproducibility of Results ; Republic of Korea/epidemiology ; Risk Factors ; Sensitivity and Specificity ; Stroke/diagnostic imaging ; Stroke/epidemiology* ; Tomography, X-Ray Computed/statistics & numerical data
Keywords
Aged ; Brain Ischemia/diagnostic imaging ; Brain Ischemia/epidemiology* ; Calcinosis/diagnostic imaging ; Calcinosis/epidemiology* ; Causality ; Comorbidity ; Coronary Angiography/statistics & numerical data ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/epidemiology* ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Prognosis ; Reproducibility of Results ; Republic of Korea/epidemiology ; Risk Factors ; Sensitivity and Specificity ; Stroke/diagnostic imaging ; Stroke/epidemiology* ; Tomography, X-Ray Computed/statistics & numerical data
Abstract
PURPOSE: To examine the associations between intracranial artery calcifications (IACs) and coronary artery calcifications (CACs) in patients with ischemic stroke and to assess the predictive value of IAC for asymptomatic coronary artery disease (CAD). MATERIALS AND METHODS: This retrospective study, approved by an institutional review board that waived the need for informed consent, included 314 consecutive patients who had acute ischemic stroke and who underwent both brain and coronary computed tomography (CT) within 1 month of stroke. IAC was quantified semiautomatically by calculating both Agatston scores (area of calcification multiplied by a weighted value assigned to its highest Hounsfield unit) and volumes on thin-section unenhanced images and was correlated with coronary calcium scores and volumes. Quartiles were created for IAC scores and were used for logistic regression analysis. An optimal IAC score cutoff value was determined and used to predict the presence of asymptomatic CAD. Independent factors for asymptomatic CAD were assessed by using multiple logistic regression analysis. Receiver operating characteristic curve analysis was performed to evaluate the added value of IAC scores for prediction of asymptomatic CAD. RESULTS: IAC and CAC were significantly correlated for both Agatston scores and volumes (R = 0.665 and 0.663, respectively; P < .001). A graded association was found between IAC scores and presence of asymptomatic CAD. Both IAC scores of 120.11 or greater (odds ratio [OR], 2.57; 95% confidence interval [CI]: 1.45, 4.55) and diabetes mellitus (OR, 4.23; 95% CI: 2.42, 7.4) were independent predictors for asymptomatic CAD. Adding the IAC score to analytic models significantly improved the ability to predict asymptomatic CAD. CONCLUSION: The IAC scores quantified by using unenhanced CT correlate significantly with coronary calcium scores and may serve as an independent predictor of asymptomatic CAD in patients with ischemic stroke.
Full Text
http://pubs.rsna.org/doi/abs/10.1148/radiol.13122417?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed
DOI
10.1148/radiol.13122417
Appears in Collections:
1. College of Medicine (의과대학) > Research Institute (부설연구소) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
Kim, Eung Yeop(김응엽)
Nam, Hyo Suk(남효석) ORCID logo https://orcid.org/0000-0002-4415-3995
Ahn, Sung Soo(안성수) ORCID logo https://orcid.org/0000-0002-0503-5558
Lee, Seung Koo(이승구) ORCID logo https://orcid.org/0000-0001-5646-4072
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Han, Kyung Hwa(한경화)
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87962
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