Introduction:
Coronary artery calcium (CAC) score is a good predictor of coronary plaque burden and cardiovascular events, however its role in ischemic stroke and transient ischemic attacks (TIA) has been sparsely studied.
Methods:
Participants age ≥18 years with heart screen done from Nov 2008- Feb 2019 were selected and were assessed for documented Ischemic events (Ischemic stroke and TIA) after their heart screen. Only the most recent heart screen per person was considered. Patients were further divide into two groups based on their age. Comparisons between the two age groups was done using chi-square for categorical variables. Logistic regression was used to assess age and CAC as predictors of ischemic events and ROC curves were formed.
Results:
A total of 330896 individuals were included in the study over a span of 10 years, of which 53.9% were females. 894 (0.2%) patients were observed to have a documented diagnosis of ischemic stroke or TIA. Older patients (Age ≥50) were found to have significantly higher percentage of ischemic events as compared to young patients (3.5% vs 0.9%, p<0.001), which was also observed among various CAC groups. There was also a significant difference in distribution of CAC where older patients had higher CAC even when splitting the cohort into distinct CAC categories (P <0.001). On regression analysis elevated CAC and age were found to be a good predictors of ischemic events. Predictability of cerebrovascular ischemic events was significantly higher when elevated CAC score and patient age were considered together as compared age and CAC alone (P<0.001).
Conclusion:
Elevated coronary artery calcium score and age are a good predictor of ischemic stroke and TIA.
CORONARY ARTERY CALCIUM SCORE AS A PREDICTOR FOR INCIDENT ISCHEMIC STROKE: SYSTEMATIC REVIEW AND META-ANALYSIS
