Ischemic stroke: Measurement of intracranial artery calcifications can improve prediction of asymptomatic coronary artery disease

Sung Soo Ahn, Hyo Suk Nam, Ji Hoe Heo, Young Dae Kim, Seung Koo Lee, Kyung Hwa Han, Byoung Wook Choi, Eung Yeop Kim

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose: To examine the associations between intracranial artery calcifications (IACs) and coronary artery calcifications (CACs) in patients with ischemic stroke and to assess the predictive value of IAC for asymptomatic coronary artery disease (CAD). Materials and Methods: This retrospective study, approved by an institutional review board that waived the need for informed consent, included 314 consecutive patients who had acute ischemic stroke and who underwent both brain and coronary computed tomography (CT) within 1 month of stroke. IAC was quantified semiautomatically by calculating both Agatston scores (area of calcification multiplied by a weighted value assigned to its highest Hounsfield unit) and volumes on thin-section unenhanced images and was correlated with coronary calcium scores and volumes. Quartiles were created for IAC scores and were used for logistic regression analysis. An optimal IAC score cutoff value was determined and used to predict the presence of asymptomatic CAD. Independent factors for asymptomatic CAD were assessed by using multiple logistic regression analysis. Receiver operating characteristic curve analysis was performed to evaluate the added value of IAC scores for prediction of asymptomatic CAD. Results: IAC and CAC were significantly correlated for both Agatston scores and volumes (R = 0.665 and 0.663, respectively; P < .001). A graded association was found between IAC scores and presence of asymptomatic CAD. Both IAC scores of 120.11 or greater (odds ratio [OR], 2.57; 95% confidence interval [CI]: 1.45, 4.55) and diabetes mellitus (OR, 4.23; 95% CI: 2.42, 7.4) were independent predictors for asymptomatic CAD. Adding the IAC score to analytic models significantly improved the ability to predict asymptomatic CAD. Conclusion: The IAC scores quantified by using unenhanced CT correlate significantly with coronary calcium scores and may serve as an independent predictor of asymptomatic CAD in patients with ischemic stroke.

Original languageEnglish
Pages (from-to)842-849
Number of pages8
JournalRadiology
Volume268
Issue number3
DOIs
Publication statusPublished - 2013 Sep 1

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Coronary Artery Disease
Arteries
Stroke
Coronary Vessels
Logistic Models
Odds Ratio
Tomography
Regression Analysis
Confidence Intervals
Calcium
Research Ethics Committees
Informed Consent
ROC Curve
Diabetes Mellitus
Retrospective Studies
Brain

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Ahn, Sung Soo ; Nam, Hyo Suk ; Heo, Ji Hoe ; Kim, Young Dae ; Lee, Seung Koo ; Han, Kyung Hwa ; Choi, Byoung Wook ; Kim, Eung Yeop. / Ischemic stroke : Measurement of intracranial artery calcifications can improve prediction of asymptomatic coronary artery disease. In: Radiology. 2013 ; Vol. 268, No. 3. pp. 842-849.
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abstract = "Purpose: To examine the associations between intracranial artery calcifications (IACs) and coronary artery calcifications (CACs) in patients with ischemic stroke and to assess the predictive value of IAC for asymptomatic coronary artery disease (CAD). Materials and Methods: This retrospective study, approved by an institutional review board that waived the need for informed consent, included 314 consecutive patients who had acute ischemic stroke and who underwent both brain and coronary computed tomography (CT) within 1 month of stroke. IAC was quantified semiautomatically by calculating both Agatston scores (area of calcification multiplied by a weighted value assigned to its highest Hounsfield unit) and volumes on thin-section unenhanced images and was correlated with coronary calcium scores and volumes. Quartiles were created for IAC scores and were used for logistic regression analysis. An optimal IAC score cutoff value was determined and used to predict the presence of asymptomatic CAD. Independent factors for asymptomatic CAD were assessed by using multiple logistic regression analysis. Receiver operating characteristic curve analysis was performed to evaluate the added value of IAC scores for prediction of asymptomatic CAD. Results: IAC and CAC were significantly correlated for both Agatston scores and volumes (R = 0.665 and 0.663, respectively; P < .001). A graded association was found between IAC scores and presence of asymptomatic CAD. Both IAC scores of 120.11 or greater (odds ratio [OR], 2.57; 95{\%} confidence interval [CI]: 1.45, 4.55) and diabetes mellitus (OR, 4.23; 95{\%} CI: 2.42, 7.4) were independent predictors for asymptomatic CAD. Adding the IAC score to analytic models significantly improved the ability to predict asymptomatic CAD. Conclusion: The IAC scores quantified by using unenhanced CT correlate significantly with coronary calcium scores and may serve as an independent predictor of asymptomatic CAD in patients with ischemic stroke.",
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Ischemic stroke : Measurement of intracranial artery calcifications can improve prediction of asymptomatic coronary artery disease. / Ahn, Sung Soo; Nam, Hyo Suk; Heo, Ji Hoe; Kim, Young Dae; Lee, Seung Koo; Han, Kyung Hwa; Choi, Byoung Wook; Kim, Eung Yeop.

In: Radiology, Vol. 268, No. 3, 01.09.2013, p. 842-849.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Ischemic stroke

T2 - Measurement of intracranial artery calcifications can improve prediction of asymptomatic coronary artery disease

AU - Ahn, Sung Soo

AU - Nam, Hyo Suk

AU - Heo, Ji Hoe

AU - Kim, Young Dae

AU - Lee, Seung Koo

AU - Han, Kyung Hwa

AU - Choi, Byoung Wook

AU - Kim, Eung Yeop

PY - 2013/9/1

Y1 - 2013/9/1

N2 - Purpose: To examine the associations between intracranial artery calcifications (IACs) and coronary artery calcifications (CACs) in patients with ischemic stroke and to assess the predictive value of IAC for asymptomatic coronary artery disease (CAD). Materials and Methods: This retrospective study, approved by an institutional review board that waived the need for informed consent, included 314 consecutive patients who had acute ischemic stroke and who underwent both brain and coronary computed tomography (CT) within 1 month of stroke. IAC was quantified semiautomatically by calculating both Agatston scores (area of calcification multiplied by a weighted value assigned to its highest Hounsfield unit) and volumes on thin-section unenhanced images and was correlated with coronary calcium scores and volumes. Quartiles were created for IAC scores and were used for logistic regression analysis. An optimal IAC score cutoff value was determined and used to predict the presence of asymptomatic CAD. Independent factors for asymptomatic CAD were assessed by using multiple logistic regression analysis. Receiver operating characteristic curve analysis was performed to evaluate the added value of IAC scores for prediction of asymptomatic CAD. Results: IAC and CAC were significantly correlated for both Agatston scores and volumes (R = 0.665 and 0.663, respectively; P < .001). A graded association was found between IAC scores and presence of asymptomatic CAD. Both IAC scores of 120.11 or greater (odds ratio [OR], 2.57; 95% confidence interval [CI]: 1.45, 4.55) and diabetes mellitus (OR, 4.23; 95% CI: 2.42, 7.4) were independent predictors for asymptomatic CAD. Adding the IAC score to analytic models significantly improved the ability to predict asymptomatic CAD. Conclusion: The IAC scores quantified by using unenhanced CT correlate significantly with coronary calcium scores and may serve as an independent predictor of asymptomatic CAD in patients with ischemic stroke.

AB - Purpose: To examine the associations between intracranial artery calcifications (IACs) and coronary artery calcifications (CACs) in patients with ischemic stroke and to assess the predictive value of IAC for asymptomatic coronary artery disease (CAD). Materials and Methods: This retrospective study, approved by an institutional review board that waived the need for informed consent, included 314 consecutive patients who had acute ischemic stroke and who underwent both brain and coronary computed tomography (CT) within 1 month of stroke. IAC was quantified semiautomatically by calculating both Agatston scores (area of calcification multiplied by a weighted value assigned to its highest Hounsfield unit) and volumes on thin-section unenhanced images and was correlated with coronary calcium scores and volumes. Quartiles were created for IAC scores and were used for logistic regression analysis. An optimal IAC score cutoff value was determined and used to predict the presence of asymptomatic CAD. Independent factors for asymptomatic CAD were assessed by using multiple logistic regression analysis. Receiver operating characteristic curve analysis was performed to evaluate the added value of IAC scores for prediction of asymptomatic CAD. Results: IAC and CAC were significantly correlated for both Agatston scores and volumes (R = 0.665 and 0.663, respectively; P < .001). A graded association was found between IAC scores and presence of asymptomatic CAD. Both IAC scores of 120.11 or greater (odds ratio [OR], 2.57; 95% confidence interval [CI]: 1.45, 4.55) and diabetes mellitus (OR, 4.23; 95% CI: 2.42, 7.4) were independent predictors for asymptomatic CAD. Adding the IAC score to analytic models significantly improved the ability to predict asymptomatic CAD. Conclusion: The IAC scores quantified by using unenhanced CT correlate significantly with coronary calcium scores and may serve as an independent predictor of asymptomatic CAD in patients with ischemic stroke.

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