Παρασκευή, 22 Δεκεμβρίου 2017

Thoracic extra-coronary calcification for the prediction of stroke

Thoracic extra-coronary calcification for the prediction of stroke

  • Atherosclerosis
Multi-Ethnic Study of Atherosclerosis (MESA) followed a total of 6805 participants over a median of 12.1 years
By Ruth Frikke-Schmidt, Chief Physician, Clinical Research Associate Professor, MD, DMSc, PhD, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Sina Kianoush and co-workers report in the December 2017 issue of Atherosclerosis that multisite thoracic extra-coronary calcification (ECC) is independently associated with ischemic stroke, total stroke, and TIA. The first-author Sina Kianoush is from the Ciccarone Center for the Prevention of Heart Disease, John Hopkins Medical Institutions, Baltimore, MD, USA.
Background:  Because atherosclerosis is a systemic disease, it is of interest to evaluate whether thoracic extra-coronary calcification (ECC) improves prediction of stroke and transient ischemic attack (TIA) beyond traditional risk factors and coronary artery calcium (CAC).
Results: Using data from the Multi-Ethnic Study of Atherosclerosis (MESA), 6805 participants were followed over a median of 12.1 years. The presence of calcification at four thoracic ECC sites (mitral valve annulus, aortic valve, aortic root, and thoracic aorta) was determined from baseline CT scans. With an increasing number of thoracic ECC sites, risk of ischemic stroke, total stroke, and TIA increased. ECC did not increase risk prediction beyond traditional risk factors and CAC.
Conclusion and discussion:  Although, the multisite thoracic ECC is independently associated with ischemic stroke, total stroke, and TIA, the incremental predictive value beyond traditional risk factors and CAC appears to be minimal. More studies with larger number of stroke events are needed to show if particular subgroups defined by age, sex, race, or comorbid conditions might benefit from thoracic ECC-based stroke risk prediction.

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