The protective effect of middle cerebral artery calcification on symptomatic middle cerebral artery infarction

Jang Hyun Baek, Joonsang Yoo, Dongbeom Song, Young Dae Kim, Hyo Suk Nam, Jihoe Heo

Research output: Contribution to journalArticle

Abstract

Background and Purpose-The presence of intracranial artery calcification is associated with an increased risk for stroke. However, calcified atherosclerotic plaques are also known to be less vulnerable to rupture. Given this discrepancy, we investigated whether the vulnerability of intracranial arterial atherosclerosis differed based on the presence or absence of calcification. Methods-We considered consecutive patients with acute stroke in the unilateral middle cerebral artery (MCA) territory. Patients with any stenotic MCAs were included in this study. Symptomatic MCA was defined as the occurrence of infarctions relevant to the stenotic MCA. The presence of calcification in the MCA was evaluated on noncontrast thinsection computed tomography images using a 3dimensional software package. Generalized estimating equations were used to compare the frequency of calcification between symptomatic and asymptomatic stenosis. Results-Of the 1066 MCAs examined in 533 patients, 645 MCAs were stenotic and were included in the study. Among the 645 stenotic MCAs, 406 MCAs (62.9%) were symptomatic. Calcification was observed in 36 MCAs (5.6%). Calcification in the MCA was more frequently observed in the asymptomatic group (7.9% versus 4.2%; P=0.032). On multivariable analysis, the presence of calcification in MCA atherosclerosis was less frequent in the symptomatic group (odds ratio, 0.46; 95% confidence interval, 0.23-0.92; P=0.027). Conclusions-This study showed that calcified atherosclerosis in the MCA was less frequently symptomatic.

Original languageEnglish
Pages (from-to)3138-3141
Number of pages4
JournalStroke
Volume48
Issue number11
DOIs
Publication statusPublished - 2017 Nov 1

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Middle Cerebral Artery Infarction
Middle Cerebral Artery
Intracranial Arteriosclerosis
Stroke
Atherosclerotic Plaques
Infarction
Rupture
Atherosclerosis
Pathologic Constriction
Software
Arteries
Odds Ratio
Tomography
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

Cite this

Baek, Jang Hyun ; Yoo, Joonsang ; Song, Dongbeom ; Kim, Young Dae ; Nam, Hyo Suk ; Heo, Jihoe. / The protective effect of middle cerebral artery calcification on symptomatic middle cerebral artery infarction. In: Stroke. 2017 ; Vol. 48, No. 11. pp. 3138-3141.
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abstract = "Background and Purpose-The presence of intracranial artery calcification is associated with an increased risk for stroke. However, calcified atherosclerotic plaques are also known to be less vulnerable to rupture. Given this discrepancy, we investigated whether the vulnerability of intracranial arterial atherosclerosis differed based on the presence or absence of calcification. Methods-We considered consecutive patients with acute stroke in the unilateral middle cerebral artery (MCA) territory. Patients with any stenotic MCAs were included in this study. Symptomatic MCA was defined as the occurrence of infarctions relevant to the stenotic MCA. The presence of calcification in the MCA was evaluated on noncontrast thinsection computed tomography images using a 3dimensional software package. Generalized estimating equations were used to compare the frequency of calcification between symptomatic and asymptomatic stenosis. Results-Of the 1066 MCAs examined in 533 patients, 645 MCAs were stenotic and were included in the study. Among the 645 stenotic MCAs, 406 MCAs (62.9{\%}) were symptomatic. Calcification was observed in 36 MCAs (5.6{\%}). Calcification in the MCA was more frequently observed in the asymptomatic group (7.9{\%} versus 4.2{\%}; P=0.032). On multivariable analysis, the presence of calcification in MCA atherosclerosis was less frequent in the symptomatic group (odds ratio, 0.46; 95{\%} confidence interval, 0.23-0.92; P=0.027). Conclusions-This study showed that calcified atherosclerosis in the MCA was less frequently symptomatic.",
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The protective effect of middle cerebral artery calcification on symptomatic middle cerebral artery infarction. / Baek, Jang Hyun; Yoo, Joonsang; Song, Dongbeom; Kim, Young Dae; Nam, Hyo Suk; Heo, Jihoe.

In: Stroke, Vol. 48, No. 11, 01.11.2017, p. 3138-3141.

Research output: Contribution to journalArticle

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T1 - The protective effect of middle cerebral artery calcification on symptomatic middle cerebral artery infarction

AU - Baek, Jang Hyun

AU - Yoo, Joonsang

AU - Song, Dongbeom

AU - Kim, Young Dae

AU - Nam, Hyo Suk

AU - Heo, Jihoe

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N2 - Background and Purpose-The presence of intracranial artery calcification is associated with an increased risk for stroke. However, calcified atherosclerotic plaques are also known to be less vulnerable to rupture. Given this discrepancy, we investigated whether the vulnerability of intracranial arterial atherosclerosis differed based on the presence or absence of calcification. Methods-We considered consecutive patients with acute stroke in the unilateral middle cerebral artery (MCA) territory. Patients with any stenotic MCAs were included in this study. Symptomatic MCA was defined as the occurrence of infarctions relevant to the stenotic MCA. The presence of calcification in the MCA was evaluated on noncontrast thinsection computed tomography images using a 3dimensional software package. Generalized estimating equations were used to compare the frequency of calcification between symptomatic and asymptomatic stenosis. Results-Of the 1066 MCAs examined in 533 patients, 645 MCAs were stenotic and were included in the study. Among the 645 stenotic MCAs, 406 MCAs (62.9%) were symptomatic. Calcification was observed in 36 MCAs (5.6%). Calcification in the MCA was more frequently observed in the asymptomatic group (7.9% versus 4.2%; P=0.032). On multivariable analysis, the presence of calcification in MCA atherosclerosis was less frequent in the symptomatic group (odds ratio, 0.46; 95% confidence interval, 0.23-0.92; P=0.027). Conclusions-This study showed that calcified atherosclerosis in the MCA was less frequently symptomatic.

AB - Background and Purpose-The presence of intracranial artery calcification is associated with an increased risk for stroke. However, calcified atherosclerotic plaques are also known to be less vulnerable to rupture. Given this discrepancy, we investigated whether the vulnerability of intracranial arterial atherosclerosis differed based on the presence or absence of calcification. Methods-We considered consecutive patients with acute stroke in the unilateral middle cerebral artery (MCA) territory. Patients with any stenotic MCAs were included in this study. Symptomatic MCA was defined as the occurrence of infarctions relevant to the stenotic MCA. The presence of calcification in the MCA was evaluated on noncontrast thinsection computed tomography images using a 3dimensional software package. Generalized estimating equations were used to compare the frequency of calcification between symptomatic and asymptomatic stenosis. Results-Of the 1066 MCAs examined in 533 patients, 645 MCAs were stenotic and were included in the study. Among the 645 stenotic MCAs, 406 MCAs (62.9%) were symptomatic. Calcification was observed in 36 MCAs (5.6%). Calcification in the MCA was more frequently observed in the asymptomatic group (7.9% versus 4.2%; P=0.032). On multivariable analysis, the presence of calcification in MCA atherosclerosis was less frequent in the symptomatic group (odds ratio, 0.46; 95% confidence interval, 0.23-0.92; P=0.027). Conclusions-This study showed that calcified atherosclerosis in the MCA was less frequently symptomatic.

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