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Ischemic stroke/transient ischemic attack events and carotid artery disease in the absence of or with minimal coronary artery calcification: Results from the Multi-Ethnic Study of Atherosclerosis

Citation

Osawa, K and Nakanishi, R and McClelland, RL and Polak, JF and Bishop, W and Sacco, RL and Ceponiene, I and Nezarat, N and Rahmani, S and Qi, H and Kanisawa, M and Budoff, MJ, Ischemic stroke/transient ischemic attack events and carotid artery disease in the absence of or with minimal coronary artery calcification: Results from the Multi-Ethnic Study of Atherosclerosis, Atherosclerosis, 275 pp. 22-27. ISSN 0021-9150 (2018) [Refereed Article]


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DOI: doi:10.1016/j.atherosclerosis.2018.05.027

Abstract

Background and aims: The association between minimally elevated coronary artery calcification (CAC) and cerebrovascular disease is not well known. We assessed whether individuals with minimal CAC (Agatston scores of 1e10) have higher ischemic stroke or transient ischemic attack (TIA) frequencies compared with those with no CAC.We also investigated the relative prevalence of carotid atherosclerosis in these two groups.

Methods: A total of 3924 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) without previous cardiovascular events, including stroke, and with baseline CAC scores of 0e10 were followed for the occurrence of incident ischemic stroke/TIA. We used carotid ultrasound to detect carotid artery plaques and to measure the intima-media thickness (IMT).

Results: During a median follow-up of 13.2 years, 130 participants developed incident ischemic stroke/ TIA. There was no significant difference in the ischemic stroke/TIA incidence between those with minimal CAC and no CAC (3.7 versus 2.7 per 1000 person-years). In participants with minimal CAC, we observed a significant association of the condition with an internal carotid artery (ICA) that had a greaterthan- average IMT (ICA-IMT; β 0.071, p 0.001) and a higher odds ratio (OR) for carotid artery plaques (OR 1.46; with a 95% confidence interval [CI] of 1.18e1.80; p < 0.001).

Conclusions: A CAC score of 0e10 is associated with a low rate of ischemic stroke/TIA, and thus a minimal CAC score is not a valuable predictive marker for ischemic stroke/TIA. A minimal CAC score may, however, provide an early and asymptomatic sign of carotid artery disease.

Item Details

Item Type:Refereed Article
Keywords:carotid artery intima-media thickness, carotid artery lesion, coronary artery calcification, ischemic stroke/Transient ischemic attack
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
Author:Bishop, W (Dr Warrick Bishop)
ID Code:129034
Year Published:2018
Deposited By:Menzies Institute for Medical Research
Deposited On:2018-11-05
Last Modified:2018-11-06
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