Vertebrobasilar Artery Calcification as a Risk Factor for the Development of Stroke: Case-Control Study From a
Kibballi M Adarsh1, H Pavithra2, Valiyapalathingal Abdul Rasheed1
1Radiodiagnosis and Medical Imaging, Yenepoya Medical College Hospital, Mangaluru, IND.
Insights
Calcification in vertebrobasilar arteries is a significant risk factor for stroke, particularly when combined with diabetes or high cholesterol. Higher grades of calcification indicate an increased stroke risk.
Area of Science:
- Neurology
- Vascular Medicine
- Radiology
Background:
- Stroke is a leading cause of death and disability globally, especially in developing nations.
- Established stroke risk factors include hypertension, diabetes, and dyslipidemia.
- Calcification of the vertebrobasilar arteries' media and intima layers is an understudied potential stroke risk factor.
Purpose of the Study:
- To evaluate the association between vertebrobasilar artery calcification and stroke.
- To compare calcification degrees in stroke patients versus controls.
- To assess the risk of stroke development related to calcification and other factors.
Main Methods:
- A hospital record-based case-control study.
- Inclusion of 150 stroke patients (cases) and age/gender-matched controls without stroke.
- Assessment of vertebrobasilar artery calcification via computed tomography imaging, alongside other stroke risk factors.
Main Results:
- Higher degrees of calcification in the right and left vertebral arteries were significantly more prevalent in stroke cases compared to controls (aOR 6.61, p<0.001; aOR 2.32, p=0.032).
- Stroke risk increased with elevated calcification grades, diabetes mellitus, and high cholesterol levels (aOR 9.98, 2.32, and 4, respectively).
- The presence of multiple risk factors further elevated stroke risk.
Conclusions:
- Significant calcification in vertebrobasilar arteries is a major risk factor for stroke.
- Detecting moderate to severe calcification in these arteries, even in asymptomatic individuals, warrants consideration as a stroke warning sign.
Abstract:
Background Stroke is an important cause of morbidity and mortality in developing countries. Many risk factors are well-established for the development of stroke. Atherosclerosis involving the media and intima layer of vertebrobasilar arteries has not been studied well as a risk factor for stroke. Objective To assess the degree of calcification of vertebrobasilar arteries among patients with stroke (cases), age- and gender-matched controls, and the risk of the development of stroke. Methods This was a hospital record-based case-control study with individuals with stroke as cases and age- and gender-matched individuals without stroke as controls, who underwent computed tomography imaging. The degree of calcification of vertebrobasilar arteries was assessed among cases and controls. Various other risk factors for the development of stroke such as the presence of hypertension, diabetes mellitus, and impaired lipid profile were also assessed. Results Among the 150 cases and their age- and gender-matched controls, the mean age of the subjects was 58.38 (±14.06) years. Forty percent of the individuals were males. Among the cases, right vertebral, left vertebral, and basilar artery calcifications were observed among 114 (76%), 102 (68%), and 52 (34.7%), respectively. Among controls, 71 (47.3%), 77 (51.3%), and 29 (19.3%) individuals had right vertebral, left vertebral, and basilar artery calcifications, respectively. The degree of calcification was higher among the cases in the right and left vertebral arteries than the controls (adjusted odds (aOR) of 6.61 and 2.32 and p-value <0.001 and 0.032, respectively). The risk of stroke increased with higher degrees of calcification, the presence of diabetes mellitus, and raised cholesterol levels (aOR of 9.98, 2.32, and 4 and p-value <0.001, 0.007, and 0.001, respectively). The risk of stroke increases with the presence of multiple risk factors. Conclusion The presence of higher grades of calcifications in the vertebrobasilar arteries is a major risk factor for stroke. Hence, its presence in asymptomatic individuals needs to be taken as a warning sign for the development of stroke.
More Related Videos
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
01:26Arteries of the Head and Neck
The internal carotid arteries supply blood to the anterior portion of the cerebrum. They enter the...
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies