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Risk factors for atherosclerotic and medial arterial calcification of the intracranial internal carotid artery

2018; Elsevier BV; Volume: 276; Linguagem: Inglês

10.1016/j.atherosclerosis.2018.07.008

1879-1484

A. Vos, Remko Kockelkoren, Jill B. De Vis, Yvonne T. van der Schouw, Irene C. van der Schaaf, Birgitta K. Velthuis, Willem P.Th.M. Mali, Pim A. de Jong, Charles B.L.M. Majoie, Yvo B.W.E.M. Roos, L.E. Duijm, Koos Keizer, Aad van der Lugt, Diederik W.J. Dippel, Katarina Greve, Henri P. Bienfait, Marianne AA van Walderveen, M.J.H. Wermer, Geert J. Lycklama à Nijeholt, Jelis Boiten, D. Duyndam, Vincent I.H. Kwa, Frederick J. A. Meijer, E.J. van Dijk, F.O. Kesselring, Jeannette Hofmeijer, Jan Albert Vos, Wouter J. Schonewille, W.J. van Rooij, Paul L.M. de Kort, C.C. Pleiter, S. L. M. Bakker, Joost Bot, Marieke C. Visser, Birgitta K. Velthuis, Irene C. van der Schaaf, Jan Willem Dankbaar, Willem P.Th.M. Mali, Tom van Seeters, Alexander D. Horsch, J.M. Niesten, Geert Jan Biessels, L. Jaap Kappelle, Merel J.A. Luitse, Y. van der Graaf,

Acute Ischemic Stroke Management

Background and aimsCalcifications of the intracranial internal carotid artery (iICA) are an important risk factor for stroke. The calcifications can occur both in the intimal and medial layer of the vascular wall. The aim of this study is to assess whether medial calcification in the iICA is differently related to risk factors for cardiovascular disease, compared to intimal calcification.MethodsUnenhanced thin slice computed tomography (CT) scans from 1132 patients from the Dutch acute stroke study cohort were assessed for dominant localization of calcification (medial or intimal) by one of three observers based on established methodology. Associations between known cardiovascular risk factors (age, gender, body mass index, pulse pressure, eGFR, smoking, hypertension, diabetes mellitus, hyperlipidemia, previous vascular disease, and family history) and the dominant localization of calcifications were assessed via logistic regression analysis.ResultsIn the 1132 patients (57% males, mean age 67.4 years [SD 13.8]), dominant intimal calcification was present in 30.9% and dominant medial calcification in 46.9%. In 10.5%, no calcification was seen. Age, pulse pressure and family history were risk factors for both types of calcification. Multivariably adjusted risk factors for dominant intimal calcification only were smoking (OR 2.09 [CI 1.27–3.44]) and hypertension (OR 2.09 [CI 1.29–3.40]) and for dominant medial calcification diabetes mellitus (OR 2.39 [CI 1.11–5.14]) and previous vascular disease (OR 2.20 [CI 1.30–3.75]).ConclusionsRisk factors are differently related to the dominant localizations of calcifications, a finding that supports the hypothesis that the intimal and medial calcification represents a distinct etiology.