Carotid, aortic arch and coronary calcification are related to history of stroke: The Rotterdam Study

Elias-Smale, Suzette E.; Odink, Arlette E.; Wieberdink, Renske G.; Hofman, Albert; Hunink, Myriam G.M.; Krestin, Gabriel P.; Koudstaal, Peter J.; Breteler, Monique M.B.; van der Lugt, Aad; Witteman, Jacqueline C.M.

doi:10.1016/j.atherosclerosis.2010.06.037

« Previous Next »Atherosclerosis
Volume 212, Issue 2 , Pages 656-660, October 2010

Carotid, aortic arch and coronary calcification are related to history of stroke: The Rotterdam Study

Suzette E. Elias-Smale
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
Arlette E. Odink
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
Renske G. Wieberdink
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
Myriam G.M. Hunink
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
Gabriel P. Krestin
- Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
Peter J. Koudstaal
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
Monique M.B. Breteler
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
Aad van der Lugt
- Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
Jacqueline C.M. Witteman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Corresponding author at: Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands, Tel.: +31 10 7043489; fax: +31 10 7044657.

Received 12 May 2010; received in revised form 18 June 2010; accepted 18 June 2010. published online 21 July 2010.

Abstract

Objective

Multidetector computed tomography (MDCT), which has been mainly used to study coronary atherosclerosis, also enables non-invasive measurement of carotid and aortic atherosclerosis and might be suitable for screening in the general population. The aim of this study was to investigate the associations of carotid artery, aortic arch and coronary artery calcification as assessed by MDCT, with presence of stroke.

Methods

The study was embedded in the population-based Rotterdam Study and comprises 2521 persons (mean age 69.7±6.8 years, 48% males) that underwent an MDCT scan. History of stroke was reported by 96 persons. We used multivariable logistic regression to investigate the associations of calcification in the carotid arteries, aortic arch, and coronary arteries with presence of stroke.

Results

We found strong and graded associations of prevalent stroke with carotid artery (OR quartile 4 versus 1 (95% CI): 5.0 (2.2–11.0)), aortic arch (3.3 (1.5–7.4)) and coronary artery calcification (3.1 (1.3–7.3)), independent of cardiovascular risk factors. Only the association of carotid artery calcification with presence of stroke was independent of calcification in the other two vessel beds.

Conclusion

In this population-based study, we found a strong and graded association of prevalent stroke with carotid artery, aortic arch and coronary artery calcification, independent of cardiovascular risk factors. After additional adjustment for calcification in the other vessel beds, prevalent stroke was still significantly related to carotid calcification, but no longer to aortic arch or coronary calcification.

Keywords: Atherosclerosis, Arterial calcification, Carotid arteries, Thoracic aorta, Stroke