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

Autor: Vivek Sharma, Wan Yee Kong, Bernard P.L. Chan, Nicholas Jh Ngiam, Leonard L.L. Yeo, Benjamin Yong-Qiang Tan, Wilson Gw Goh, Eide Sterling Ellis
Rok vydání: 2019
Předmět:
Carotid Artery Diseases
Male
Middle Cerebral Artery
Time Factors
Computed Tomography Angiography
Cerebral arteries
Severity of Illness Index
0302 clinical medicine
Recurrence
Risk Factors
Registries
Stroke
Vertebral Artery
First episode
Univariate analysis
biology
Rehabilitation
Intracranial Artery
Arteries
Middle Aged
Prognosis
Arterial calcification
Ischemic Attack
Transient
Basilar Artery
Cohort
Cardiology
Female
Cerebral Arterial Diseases
Cardiology and Cardiovascular Medicine
Carotid Artery
Internal
Adult
medicine.medical_specialty
Risk Assessment
03 medical and health sciences
Predictive Value of Tests
Internal medicine
ABCD2
medicine
Humans
cardiovascular diseases
Vascular Calcification
Aged
Retrospective Studies
business.industry
medicine.disease
nervous system diseases
Cerebral Angiography
biology.protein
Surgery
Neurology (clinical)
business
030217 neurology & neurosurgery
Zdroj: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 28(8)
ISSN: 1532-8511
Popis: Background: Patients with initial transient ischaemic attack (TIA) subsequently have a higher risk of recurrent TIA or acute ischemic stroke (AIS). The role of scoring intracranial arterial calcification (IAC) in predicting the prevalence of stroke remains unclear. We aim to evaluate if radiological CT calcium score measuring IAC burden could predict future ischemic events in a cohort of TIA patients. Methods: We studied consecutive patients from July 2014 to December 2015 who presented with first episode of TIA. All patients had noncontrasted CT or CT-angiogram of the brain on admission. CT calcium score (cm3) was quantified by measuring calcium deposition in the bilateral internal carotid arteries, middle cerebral arteries, and vertebrobasilar system. Patients were followed up for 2 years and ischemic events for either recurrent TIA or AIS were recorded. We compared patients in terms of clinical profile at presentation and CT calcium score using appropriate univariate and multivariable analyses. Results: Of 156 TIA patients studied, 22% (n = 35) had recurrent TIA or AIS within 2 years of follow-up. On univariate analyses, recurrent TIA/AIS was associated with gender (OR 0.61; 95%CI 0.40-0.95; P = .038), hypertension (mean difference 2.49; 95%CI 1.08-5.75; P = .030) and higher CT calcium score (mean difference 0.84 95%CI 0.16-1.52 P = .016). On multivariable logistic regression, a higher CT calcium score was significantly associated with recurrent TIA/AIS (adjusted OR 1.25 95%CI 1.01-1.55 P = .042). Conclusions: In TIA patients, higher IAC burden by measurement of a quantitative CT calcium score may be associated with recurrent ischemic events.
Databáze: OpenAIRE
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