Risk factors for atherosclerotic and medial arterial calcification of the intracranial internal carotid artery

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Abstract

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.

Original languageEnglish
Pages (from-to)44-49
Number of pages6
JournalAtherosclerosis
Volume276
DOIs
Publication statusPublished - 1 Sep 2018
Externally publishedYes

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Tunica Intima
Internal Carotid Artery
Vascular Diseases
Diabetes Mellitus
Smoking
Stroke
Blood Pressure
Hypertension
Hyperlipidemias
Blood Vessels
Body Mass Index
Cohort Studies
Cardiovascular Diseases
Logistic Models
Tomography
Regression Analysis

Keywords

  • Atherosclerosis
  • Cardiovascular disease risk factors
  • Intracranial carotid artery
  • Medial arterial calcification

Cite this

@article{630fc38bdfe94c99a71886ad0e152366,
title = "Risk factors for atherosclerotic and medial arterial calcification of the intracranial internal carotid artery",
abstract = "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.",
keywords = "Atherosclerosis, Cardiovascular disease risk factors, Intracranial carotid artery, Medial arterial calcification",
author = "Annelotte Vos and Remko Kockelkoren and {de Vis}, {Jill B.} and {van der Schouw}, {Yvonne T.} and {van der Schaaf}, {Irene C.} and Velthuis, {Birgitta K.} and Mali, {Willem P.T.M.} and {de Jong}, {Pim A.} and Majoie, {C. B.} and Y.B. Roos and L.E. Duijm and K. Keizer and {van der Lugt}, A. and D.W. Dippel and {Droogh-de Greve}, K.E. and H.P. Bienfait and {van Walderveen}, M.A. and Wermer, {M. J.H.} and {Lycklama {\`a} Nijeholt}, G.J. and J. Boiten and D. Duyndam and V.I. Kwa and F.J. Meijer and {van Dijk}, E.J. and F.O. Kesselring and J. Hofmeijer and J.A. Vos and W.J. Schonewille and {van Rooij}, W.J. and {de Kort}, P.L. and C.C. Pleiter and S.L. Bakker and J. Bot and M.C. Visser and B.K. Velthuis and {van der Schaaf}, I.C. and J.W. Dankbaar and W.P. Mali and {van Seeters}, T. and A.D. Horsch and J.M. Niesten and G.J. Biessels and L.J. Kappelle and M.J. Luitse and {van der Graaf}, Y.",
year = "2018",
month = "9",
day = "1",
doi = "10.1016/j.atherosclerosis.2018.07.008",
language = "English",
volume = "276",
pages = "44--49",
journal = "Atherosclerosis",
issn = "0021-9150",
publisher = "Elsevier",

}

Risk factors for atherosclerotic and medial arterial calcification of the intracranial internal carotid artery. /.

In: Atherosclerosis, Vol. 276, 01.09.2018, p. 44-49.

Research output: Contribution to journalArticleAcademicpeer-review

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 - 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

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U2 - 10.1016/j.atherosclerosis.2018.07.008

DO - 10.1016/j.atherosclerosis.2018.07.008

M3 - Article

VL - 276

SP - 44

EP - 49

JO - Atherosclerosis

JF - Atherosclerosis

SN - 0021-9150

ER -