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Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
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Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation

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Thoracic aortic calcification is associated with incident stroke in the general population in addition to established

Dirk M Hermann1, Nils Lehmann2, Janine Gronewold3

  • 1Department of Neurology, University Hospital Essen, Hufelandstr. 55, D-45122 Essen, Germany dirk.hermann@uk-essen.de.

European Heart Journal. Cardiovascular Imaging
|January 1, 2015
PubMed

Insights

Thoracic aortic calcification (TAC) is linked to stroke risk, particularly calcification in the descending aorta. Coronary artery calcification (CAC) is a stronger stroke predictor than TAC.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Radiology

Background:

  • The aorta is a primary source of cerebral thromboembolism.
  • Non-invasive imaging of the aorta for stroke risk assessment is challenging.
  • Thoracic aortic calcification (TAC) serves as a marker for aortic plaque burden.

Purpose of the Study:

  • To investigate the association between thoracic aortic calcification (TAC) and stroke incidence.
  • To determine if TAC is an independent stroke risk factor beyond established risk factors.
  • To compare the predictive value of TAC and coronary artery calcification (CAC) for stroke.

Main Methods:

  • Utilized data from the population-based Heinz Nixdorf Recall study (3930 participants, aged 45-75).
  • Employed Cox proportional hazards regressions to analyze incident stroke events over a follow-up of approximately 109 months.
  • Assessed TAC, descending thoracic aortic calcification (DTAC), ascending thoracic aortic calcification (ATAC), and coronary artery calcification (CAC) as predictors.

Main Results:

  • 101 incident strokes occurred during the follow-up period.
  • Subjects with stroke had significantly higher baseline TAC values (P < 0.001).
  • Log(TAC + 1) was associated with stroke (HR = 1.09, P = 0.044), with DTAC showing a significant association (HR = 1.11, P = 0.016) but ATAC did not (P = 0.713).
  • The association of TAC with stroke weakened when CAC was included in the model (HR = 1.06, P = 0.202).

Conclusions:

  • Calcification of the thoracic aorta, especially the descending segment, is associated with incident stroke.
  • Thoracic aortic calcification is an independent risk factor for stroke.
  • Coronary artery calcification demonstrates superior predictive performance for stroke compared to thoracic aortic calcification.
Abstract

Keywords:
Aortic plaqueRisk stratificationStroke predictionSubclinical atherosclerosis

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