TY - JOUR
T1 - Risk factors for atherosclerotic and medial arterial calcification of the intracranial internal carotid artery
AU - Vos, Annelotte
AU - Kockelkoren, Remko
AU - de Vis, Jill B.
AU - van der Schouw, Yvonne T.
AU - van der Schaaf, Irene C.
AU - Velthuis, Birgitta K.
AU - Mali, Willem P.T.M.
AU - de Jong, Pim A.
AU - the DUST study group
AU - Majoie, C. B.
AU - Roos, Y.B.
AU - Duijm, L.E.
AU - Keizer, K.
AU - van der Lugt, A.
AU - Dippel, D.W.
AU - Droogh-de Greve, K.E.
AU - Bienfait, H.P.
AU - van Walderveen, M.A.
AU - Wermer, M. J.H.
AU - Lycklama à Nijeholt, G.J.
AU - Boiten, J.
AU - Duyndam, D.
AU - Kwa, V.I.
AU - Meijer, F.J.
AU - van Dijk, E.J.
AU - Kesselring, F.O.
AU - Hofmeijer, J.
AU - Vos, J.A.
AU - Schonewille, W.J.
AU - van Rooij, W.J.
AU - de Kort, P.L.
AU - Pleiter, C.C.
AU - Bakker, S.L.
AU - Bot, J.
AU - Visser, M.C.
AU - Velthuis, B.K.
AU - van der Schaaf, I.C.
AU - Dankbaar, J.W.
AU - Mali, W.P.
AU - van Seeters, T.
AU - Horsch, A.D.
AU - Niesten, J.M.
AU - Biessels, G.J.
AU - Kappelle, L.J.
AU - Luitse, M.J.
AU - van der Graaf, Y.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Background and aims: Calcifications of the intracranial internal carotid artery (iICA) are an important risk factor for stroke. The calcifications can occur both in the intimal and medial layer of the vascular wall. The aim of this study is to assess whether medial calcification in the iICA is differently related to risk factors for cardiovascular disease, compared to intimal calcification.Methods: Unenhanced thin slice computed tomography (CT) scans from 1132 patients from the Dutch acute stroke study cohort were assessed for dominant localization of calcification (medial or intimal) by one of three observers based on established methodology. Associations between known cardiovascular risk factors (age, gender, body mass index, pulse pressure, eGFR, smoking, hypertension, diabetes mellitus, hyperlipidemia, previous vascular disease, and family history) and the dominant localization of calcifications were assessed via logistic regression analysis.Results: In the 1132 patients (57% males, mean age 67.4 years [SD 13.8]), dominant intimal calcification was present in 30.9% and dominant medial calcification in 46.9%. In 10.5%, no calcification was seen. Age, pulse pressure and family history were risk factors for both types of calcification. Multivariably adjusted risk factors for dominant intimal calcification only were smoking (OR 2.09 [CI 1.27–3.44]) and hypertension (OR 2.09 [CI 1.29–3.40]) and for dominant medial calcification diabetes mellitus (OR 2.39 [CI 1.11–5.14]) and previous vascular disease (OR 2.20 [CI 1.30–3.75]).Conclusions: Risk factors are differently related to the dominant localizations of calcifications, a finding that supports the hypothesis that the intimal and medial calcification represents a distinct etiology.
AB - Background and aims: Calcifications of the intracranial internal carotid artery (iICA) are an important risk factor for stroke. The calcifications can occur both in the intimal and medial layer of the vascular wall. The aim of this study is to assess whether medial calcification in the iICA is differently related to risk factors for cardiovascular disease, compared to intimal calcification.Methods: Unenhanced thin slice computed tomography (CT) scans from 1132 patients from the Dutch acute stroke study cohort were assessed for dominant localization of calcification (medial or intimal) by one of three observers based on established methodology. Associations between known cardiovascular risk factors (age, gender, body mass index, pulse pressure, eGFR, smoking, hypertension, diabetes mellitus, hyperlipidemia, previous vascular disease, and family history) and the dominant localization of calcifications were assessed via logistic regression analysis.Results: In the 1132 patients (57% males, mean age 67.4 years [SD 13.8]), dominant intimal calcification was present in 30.9% and dominant medial calcification in 46.9%. In 10.5%, no calcification was seen. Age, pulse pressure and family history were risk factors for both types of calcification. Multivariably adjusted risk factors for dominant intimal calcification only were smoking (OR 2.09 [CI 1.27–3.44]) and hypertension (OR 2.09 [CI 1.29–3.40]) and for dominant medial calcification diabetes mellitus (OR 2.39 [CI 1.11–5.14]) and previous vascular disease (OR 2.20 [CI 1.30–3.75]).Conclusions: Risk factors are differently related to the dominant localizations of calcifications, a finding that supports the hypothesis that the intimal and medial calcification represents a distinct etiology.
KW - Atherosclerosis
KW - Cardiovascular disease risk factors
KW - Intracranial carotid artery
KW - Medial arterial calcification
UR - http://www.scopus.com/inward/record.url?scp=85050124174&partnerID=8YFLogxK
U2 - 10.1016/j.atherosclerosis.2018.07.008
DO - 10.1016/j.atherosclerosis.2018.07.008
M3 - Article
AN - SCOPUS:85050124174
SN - 0021-9150
VL - 276
SP - 44
EP - 49
JO - Atherosclerosis
JF - Atherosclerosis
ER -
