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Published on: May 31, 2016
Carotid artery calcification as a predictor of systemic vascular events
Noritaka Sano1,2, Tamaki Kobayashi1,3, Hiroharu Kataoka1
1Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Japan.
Insights
Carotid artery calcification, measured by the carotid Agatston calcium score (CCS), predicts systemic vascular events. A high CCS indicates a greater risk of coronary and peripheral artery events.
Area of Science:
- Cardiovascular Medicine
- Radiology
- Vascular Surgery
Background:
- Coronary calcification predicts cardiac events, but carotid artery calcification's role in systemic vascular events is unclear.
- Systemic vascular events include cerebral ischemic, coronary, and peripheral artery events.
Purpose of the Study:
- To determine if carotid calcification predicts systemic vascular events.
- To evaluate the utility of the carotid Agatston calcium score (CCS) in risk stratification.
Main Methods:
- Retrospective cohort study of 194 patients with prior vascular disease.
- Carotid calcification assessed by whole-body CT, quantified by modified carotid Agatston calcium score (CCS).
- Patients stratified into high (≥126) and low (<126) CCS groups for 5-year event monitoring.
Main Results:
- Older age, hypertension, and chronic kidney disease correlated with higher CCS.
- High CCS group showed significantly increased incidence of systemic vascular events (HR: 2.70), coronary events (HR: 4.29), and peripheral vascular events.
Conclusions:
- The carotid Agatston calcium score (CCS) is a potential predictor of future systemic vascular events.
- CCS may aid in identifying patients at higher risk for coronary and peripheral artery diseases.
Background:
Coronary calcification is a well-known predictor of coronary events, yet the impact of carotid artery calcification on systemic vascular events (e.g., cerebral ischemic, coronary, and peripheral artery events) remains unclear. The aim of this study was to determine whether carotid calcification can be used to predict systemic vascular events.
Methods:
This single-center, retrospective cohort study included 194 patients who had a history of vascular disease, including carotid stenosis or occlusion, coronary artery disease, valvular heart disease, ischemic stroke, or transient ischemic attack. We collected data pertaining to risk factors and laboratory parameters. Calcification of the carotid arteries was assessed via whole-body computed tomography, and the modified carotid Agatston calcium score (CCS) was determined. Participants were divided into two CCS groups according to the cut-off value determined via receiver operating characteristic curve analysis; high CCS ≥ 126 and low CCS < 126. Coronary, ischemic cerebrovascular, and peripheral vascular events were recorded over a 5-year follow-up period, and their incidence was compared between the groups using Cox proportional hazards regression analysis.
Results:
Older age, hypertension, and chronic kidney disease had a significant positive impact on the CCS. Systemic vascular events (hazard ratio [HR]: 2.70, CI: 1.07-6.79, p = 0.022), coronary events (HR: 4.29, CI: 0.87-21.1, p = 0.045), and peripheral vascular events (p = 0.032) were significantly more frequent in the high versus low CCS group.
Conclusion:
The CCS may be a useful tool for predicting future systemic vascular events, including those related to coronary and peripheral artery diseases.
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