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Carotid calcifications in panoramic radiographs are associated with future stroke or ischemic heart diseases: a
Viveca Wallin Bengtsson1, G Rutger Persson2,3,4, Johan Berglund5
1University of Kristianstad, Elmetorpsvägen 15, 291 88, Kristianstad, Sweden. viveca.wallin_bengtsson@hkr.se.
Objective:
To assess if carotid calcifications detected in panoramic radiographs are associated with future events of stroke, and/or ischemic heart diseases over 10-13 years in individuals between 60 and 96 years.
Materials And Methods:
Baseline (2001-2004) panoramic radiographs were assessed for evidence of carotid calcifications from individuals with no previous history of stroke and/or ischemic heart diseases. A radiopaque nodular mass adjacent to the cervical vertebrae, at or below the intervertebral space C3-C4, was interpreted as carotid calcification. Annual medical records were searched for ICD 10 codes through 2014.
Results:
Signs of carotid calcification was demonstrated in 238/635 (37.5%) of the study individuals. Signs of carotid calcification was associated with future stroke and/or ischemic heart diseases (χ2 = 9.1, OR 1.6, 95% CI 1.2, 2.2, p < 0.002). In individuals 60-72 years, a significant association between radiographic signs of carotid calcification and stroke and/or ischemic heart diseases (χ2 = 12.4, OR 2.4, 95% CI 1.5, 4.0, p < 0.000) (adjusted for high blood pressure, diabetes type 2, BMI; OR 1.9, 95% CI 1.1, 3.5, p = 0.03). Individuals (60-72 years) with radiographic evidence of carotid calcifications had a mean cumulative stroke and/or ischemic heart diseases survival time of 12.1 years compared to those without such evidence (13.0 years) (log rank Mantel-Cox χ2 = 10.7, p = 0.001).
Conclusions:
Evidence of carotid calcifications in panoramic radiographs is associated with an event of stroke and/or ischemic heart diseases in 60-96-year-old individuals.
Clinical Relevance:
Radiographic evidence of carotid calcifications is associated with stroke and/or ischemic heart diseases. Patients with signs of carotid calcifications should therefore be referred for medical examination.
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