Eung-Yeop Kim MD, Presenter: Nothing to Disclose

Sung Soo Ahn MD, Abstract Co-Author: Nothing to Disclose

Na-Young Shin MD, Abstract Co-Author: Nothing to Disclose

As a generalized process, atherosclerosis can affect both the intracranial and coronary arteries, and their relationship has been suggested. Arterial calcifications are considered to be an integral part of atherosclerosis and may be used as a noninvasive marker of atherosclerosis on unenhanced CT. In this study, we aimed to examine the associations between calcifications in the intracranial and coronary arteries after quantifying them on unenhanced CT in patients with ischemic stroke, and to assess the predictive value of intracranial artery calcification (ICAC) for coronary artery disease (CAD; 1 or more arteries > 50% stenosis).

We retrospectively included 104 consecutive patients who had acute ischemic stroke and underwent both unenhanced brain and coronary CT within one month. Each of 4.8-mm brain CT images was reconstructed into four 1.2-mm images. We quantified ICACs semi-automatically by calculating both the Agatston score and volume on these thin images and correlated them with coronary calcium score. Based on the Agatston score, the ICACs were categorized into 5 grades with cut-off points of 300, 600, 900, and 1200, and their grades were used for logistic regression analysis. Independent factors associated with CAD were assessed using multivariate logistic regression analysis.

CAD was found in 52 patients (50%). Correlation coefficients (r) between ICAC and coronary calcium score were 0.65 for Agatston score and 0.64 for volume measurement (P < 0.001). Vertebrobasilar artery calcification was less correlated with coronary calcium score than internal carotid artery calcification (r = 0.455 vs. 0.654 for Agatston score and 0.454 vs. 0.643 for volume). Of known vascular risk factors, multivariate analysis revealed that the ICAC grade was the only independent factor associated with CAD (Odds ratio, 2.361; P < 0.001). All patients with Agatston score higher than 900 in the intracranial artery (n = 18) had CAD.

Calcification of the intracranial arteries correlates well with coronary calcium score and can predict the presence of CAD in ischemic stroke patients.

A significant number of patients with ischemic stroke have combined CAD. Intracranial calcification quantified using unenhanced CT may serve as a predictor for the presence of CAD.

Kim, E, Ahn, S, Shin, N, Intracranial Artery Calcification as a Predictor of Coronary Artery Disease in Patients with Ischemic Stroke.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12028107.html