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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

Osawa, K, Nakanishi, R, McClelland, RL, Polak, JF, Bishop, W, Sacco, RL, Ceponiene, I, Nezarat, N, Rahmani, S, Qi, H, Kanisawa, M and Budoff, MJ 2018 , '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, vol. 275 , pp. 22-27 , doi: 10.1016/j.atherosclerosis.2018.05.027.

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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) frequenciescompared with those with no CAC.We also investigated the relative prevalence of carotid atherosclerosisin these two groups.Methods: A total of 3924 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) withoutprevious cardiovascular events, including stroke, and with baseline CAC scores of 0e10 were followed forthe occurrence of incident ischemic stroke/TIA. We used carotid ultrasound to detect carotid arteryplaques 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 minimalCAC and no CAC (3.7 versus 2.7 per 1000 person-years). In participants with minimal CAC, weobserved a significant association of the condition with an internal carotid artery (ICA) that had a greaterthan-average IMT (ICA-IMT; β ¼ 0.071, p ¼ 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 Conclusions: A CAC score of 0e10 is associated with a low rate of ischemic stroke/TIA, and thus a minimalCAC 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 Type: Article
Authors/Creators: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
Keywords: carotid artery intima-media thickness, carotid artery lesion, coronary artery calcification, ischemic stroke/Transient ischemic attack
Journal or Publication Title: Atherosclerosis
Publisher: Elsevier
ISSN: 0021-9150
DOI / ID Number: 10.1016/j.atherosclerosis.2018.05.027
Copyright Information:

© 2018 Elsevier B.V. All rights reserved.

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