Intracranial Artery Calcium Burden Predicts Recurrent Cerebrovascular Events in Transient Ischaemic Attack Patients

Area of Science:

• Neurology
• Radiology
• Cardiovascular Science

Background:

• Patients experiencing an initial transient ischemic attack (TIA) face an elevated risk of subsequent recurrent TIA or acute ischemic stroke (AIS).
• The predictive value of quantifying intracranial arterial calcification (IAC) burden for stroke risk in TIA patients is not well-established.

Purpose of the Study:

• To investigate whether a radiological computed tomography (CT) calcium score, measuring IAC burden, can predict future ischemic events in a cohort of TIA patients.
• To evaluate the association between IAC burden and the occurrence of recurrent TIA or AIS within a 2-year follow-up period.

Main Methods:

• A cohort of consecutive patients presenting with their first TIA episode between July 2014 and December 2015 were studied.
• Non-contrast CT or CT-angiogram of the brain was performed on admission. CT calcium score was quantified by measuring calcium deposition in key intracranial arteries.
• Patients were followed for 2 years to record recurrent TIA or AIS events. Univariate and multivariable analyses were used to compare clinical profiles and CT calcium scores.

Main Results:

• Out of 156 TIA patients, 22% experienced recurrent TIA or AIS within 2 years.
• Univariate analysis revealed associations between recurrent events and gender, hypertension, and higher CT calcium scores.
• Multivariable logistic regression demonstrated that a higher CT calcium score was significantly associated with recurrent TIA/AIS (adjusted OR 1.25; 95% CI 1.01-1.55).

Conclusions:

• A higher intracranial arterial calcification burden, quantified by CT calcium score, may be associated with an increased risk of recurrent ischemic events in patients with TIA.
• Quantitative CT calcium scoring could serve as a valuable tool for predicting future ischemic events in TIA patients.