Author + information
- Kazuhiro Osawa,
- Rine Nakanishi,
- Robyn McClelland,
- Ralph Sacco,
- Joseph Polak,
- Warrick Bishop,
- Negin Nezarat,
- Mitsuru Kanisawa,
- Sina Rahmani,
- Indre Ceponience,
- Hong Qi and
- Matthew Budoff
Background: An elevated CAC (coronary artery calcification) is a marker of increased cerebrovascular disease risk. However, cerebrovascular events also occur in individuals with little or no CAC. In this study, we aim to assess whether individuals with minimal CAC (1-10) have similar or higher cerebrovascular events rates compared to those with a CAC score of zero. We also investigate the prevalence of carotid artery plaques in individuals with little or no CAC.
Methods: Asymptomatic participants with baseline CAC score of 0-10 in the Multi-Ethnic Study of Atherosclerosis (MESA) (n=3924) were followed for occurrence of cerebrovascular events (including stroke and transient ischemic attack). Carotid ultrasonography examination was performed to assess carotid plaque and internal carotid artery (ICA) intima media thickness (IMT). Models for events were adjusted only for age, gender and race due to the small sample size. Models for ultrasound variables were also adjusted for diabetes, body mass index, blood pressure, lipids, smoking, family history and medications.
Results: Of 3924 subjects, 87.1 percent (n=3416) had a CAC score of zero, whereas 12.9% (n=508) had CAC score of 1-10. During a median follow-up of 11 years, there were 113 cerebrovascular events. Although individuals with minimum CAC had a slightly greater incidence of cerebrovascular events compared to those with a CAC score of zero (3.4% vs. 2.8%), the association was not significant in age, gender, race/ethnicity adjusted analysis (hazard ratio [HR]; 1.06, 95% CI 0.63-1.80). In contrast, multivariable adjustment analysis showed a significant positive association between the presence of minimal CAC with greater average ICA-IMT (coefficient=0.07, p=0.001) and higher likelihood of carotid artery plaque (odds ratio [OR]; 1.46, 95% CI 1.18-1.80, p<0.001) compared to those with a CAC score of zero.
Conclusions: Although minimal CAC was not predictive of cerebrovascular events, it was significantly associated with worse carotid artery disease compared with a CAC score of zero. Measuring CAC may potentially provide an incremental value in early detection of subclinical cerebrovascular disease.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Non Invasive Imaging: Coronary Calcium Scoring and CV Risk Assessment
Abstract Category: 27. Non Invasive Imaging: CT/Multimodality, Angiography, and Non-CT Angiography
Presentation Number: 1198-239
- 2017 American College of Cardiology Foundation