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Stroke is associated with coronary calcification as detected by electron-beam CT: the Rotterdam Coronary
Rozemarijn Vliegenthart1, Monika Hollander, Monique M B Breteler
1Department of Epidemiology & Biostatistics, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
Insights
Coronary calcification detected by electron-beam CT is associated with an increased risk of stroke. Higher calcium scores indicate a greater likelihood of stroke, suggesting its utility in identifying high-risk individuals.
Area of Science:
- Cardiovascular disease research
- Neuroscience
- Medical imaging
Background:
- Atherosclerosis is a systemic process affecting the entire vascular tree.
- Coronary calcification, a marker of atherosclerotic plaque burden, predicts coronary events.
- The relationship between coronary calcification and stroke requires further investigation.
Purpose of the Study:
- To investigate the association between coronary calcification detected by electron-beam CT and the presence of stroke.
- To determine if coronary calcification can serve as a predictor for stroke risk.
Main Methods:
- Prospective Rotterdam Coronary Calcification Study embedded within the Rotterdam Study.
- Electron-beam CT used to detect and quantify coronary calcification using Agatston's method.
- Calcium scores analyzed in 2013 subjects (mean age 71 years), with 50 having prior stroke.
Main Results:
- A graded association exists between coronary calcification and stroke.
- Subjects with calcium scores of 101-500 were twice as likely to have had a stroke (OR, 2.1).
- Subjects with calcium scores >500 were three times more likely to have had a stroke (OR, 3.3).
- Risk estimates remained significant after adjusting for cardiovascular risk factors.
Conclusions:
- Coronary calcification detected by electron-beam CT shows a strong, graded association with stroke.
- Electron-beam CT-detected coronary calcification may help identify individuals at elevated risk of stroke.
- This finding supports the role of coronary calcification as a potential biomarker for cerebrovascular disease.
Background And Purpose:
Coronary calcification as detected by electron-beam CT measures the atherosclerotic plaque burden and has been reported to predict coronary events. Because atherosclerosis is a generalized process, coronary calcification may also be associated with manifest atherosclerotic disease at other sites of the vascular tree. We examined whether coronary calcification as detected by electron-beam CT is related to the presence of stroke.
Methods:
From 1997 onward, subjects were invited to participate in the prospective Rotterdam Coronary Calcification Study and undergo electron-beam CT to detect coronary calcification. The study was embedded in the population-based Rotterdam Study. Calcifications were quantified in a calcium score according to Agatston's method. Calcium scores were available for 2013 subjects (mean age [SD], 71 [5.7] years). Fifty subjects had experienced stroke before scanning.
Results:
Subjects were 2 times more likely to have experienced stroke when their calcium score was between 101 and 500 (odds ratio [OR], 2.1; 95% CI, 0.9 to 4.7) and 3 times more likely when their calcium score was above 500 (OR, 3.3; 95% CI, 1.5 to 7.2), compared with subjects in the lowest calcium score category (0 to 100). Additional adjustment for cardiovascular risk factors did not materially alter the risk estimates.
Conclusions:
In this population-based study, a markedly graded association was found between coronary calcification and stroke. The results suggest that coronary calcification as detected by electron-beam CT may be useful to identify subjects at high risk of stroke.