Background and Objective:
It is well known that systemic arterial calcifications progress simultaneously. And coronary calcifications are a well-known predictor of coronary event in the future. Impact of carotid artery calcifications for cerebral stroke is still controversial among various articles, and the relationship between carotid artery calcifications and systemic vascular events are not known either. In this study, we aim to examine if the carotid calcification can be used as a predictor of systemic vascular events.
Methods:
This is a prospective study, which enrolled 199 subjects who have already suffered from vascular events, including carotid stenosis, coronary syndromes or stroke. We collected data at entry on risk factors, blood examination, and whole-body computed tomography analysis to assess the calcifications of carotid, coronary, aorta (three distinct part; arch, abdominal, and bifurcation) and renal artery using modified Agatston calcium score (ACS) for each vessel. According to the median carotid ACS, subjects were divided into two groups. And during 5 years of follow up period, cerebrovascular events, coronary events and other systemic vascular events were counted.
Results:
Carotid ACS has a stronger correlation with aortic ACS than coronary ACS. Hypertension and low renal function have significant impact on increasing carotid ACS, while a diabetes mellitus increase coronary calcification. On Kaplan-Meier estimates, subjects with higher carotid ACS (higher group) suffered more systemic vascular events than lower group (p=0.03, log rank correlation coefficient), and hazard ratio was 1.88 (95%CI; 1.02-3.46). There was no significant difference in the risk of cerebral or coronary events, however, higher group have tendency to be treated for aortic or peripheral arterial disease in the follow up period (HR6.86, 0.9-54.7).
Conclusion:
Carotid ACS have strong correlation with systemic large vascular bed including aorta, and can be a useful tool to extract a subject who will be suffered from systemic vascular event in the future.