Annelotte Vos1, Remko Kockelkoren2, Jill B de Vis3, Yvonne T van der Schouw4, Irene C van der Schaaf2, Birgitta K Velthuis2, Willem P T M Mali2, Pim A de Jong2. 1. Department of Pathology, University Medical Center Utrecht and Utrecht University, Room H04.3.12, PO Box 85500, 3508GA, Utrecht, The Netherlands. Electronic address: a.vos-10@umcutrecht.nl. 2. Department of Radiology, University Medical Center Utrecht and Utrecht University, Room F01.503, PO Box 85500, 3508GA, Utrecht, The Netherlands. 3. Department of Radiology, University Medical Center Utrecht and Utrecht University, Room F01.503, PO Box 85500, 3508GA, Utrecht, The Netherlands; Department of Radiology, Johns Hopkins Medical Center, Baltimore, USA. 4. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Room 6.131, PO Box 85060, 3508AB, Utrecht, The Netherlands.
Abstract
BACKGROUND AND AIMS: Calcifications 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. METHODS: Unenhanced 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. RESULTS: In 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]). CONCLUSIONS: Risk 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.
BACKGROUND AND AIMS: Calcifications 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. METHODS: Unenhanced 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. RESULTS: In 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]). CONCLUSIONS: Risk 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.
Authors: Kars C J Compagne; Pascal R D Clephas; Charles B L M Majoie; Yvo B W E M Roos; Olvert A Berkhemer; Robert J van Oostenbrugge; Wim H van Zwam; Adriaan C G M van Es; Diederik W J Dippel; Aad van der Lugt; Daniel Bos Journal: Stroke Date: 2018-12 Impact factor: 7.914
Authors: S Voigt; Hja van Os; Maa van Walderveen; I C van der Schaaf; L J Kappelle; A Broersen; B K Velthuis; P A de Jong; R Kockelkoren; N D Kruyt; A Algra; Mjh Wermer Journal: Int J Stroke Date: 2020-09-02 Impact factor: 5.266
Authors: Wen-Jie Yang; Bruce A Wasserman; Lu Zheng; Zhong-Qing Huang; Jia Li; Jill Abrigo; Simon Sin-Man Wong; Michael Tin-Cheung Ying; Winnie Chiu-Wing Chu; Lawrence Ka-Sing Wong; Thomas Wai-Hong Leung; Xiang-Yan Chen Journal: Front Neurol Date: 2021-07-15 Impact factor: 4.003