Coronary artery calcium score as a predictor for incident stroke

Systematic review and meta-analysis

Kongkiat Chaikriangkrai, Hye Yeon Jhun, Ghanshyam Palamaner Subash Shantha, Aref Bin Abdulhak, Gardar Sigurdsson, Faisal Nabi, John J. Mahmarian, Su Min Chang

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background Coronary artery calcium score (CACS) is a well-established test for risk stratifying asymptomatic patients for overall cardiovascular or coronary events. However; the prognostic value for incident stroke remains controversial. The objective of this study was to investigate the predictive value of CACS obtained by non-contrast electrocardiogram-gated computed tomography for incident stroke. Methods We searched PubMed, EMBASE, Cochrane databases for prospective longitudinal studies of CACS which reported the incidence of stroke. Incidence of stroke was compared in patients with and without coronary calcification. Results Three studies evaluated 13,262 asymptomatic patients (mean age = 60 years, 50% men) without apparent cardiovascular diseases. During a follow-up of 7.2 years (median 5 years, range 4.4–9.5 years, 95,434 patient-years), the overall pooled incidence of stroke was 0.26%/year. The pooled risk ratio of CACS > 0 for incident stroke was 2.95 (95% CI: 2.18–4.01, p < 0.001) compared to CACS = 0. The heterogeneity among studies was low (I2 = 0%). The pooled incidence rate of stroke categorized by CACS was 0.12%/year for CACS 0, 0.26%/year for CACS 1–99, 0.41%/year for CACS 100–399 and 0.70%/year for CACS ≥ 400. Conclusions In asymptomatic patients without apparent cardiovascular diseases, the incidence of stroke was overall low. The presence and severity of coronary artery calcification were associated with incident stroke over mid-long term follow-up.

Original languageEnglish (US)
Pages (from-to)473-477
Number of pages5
JournalInternational Journal of Cardiology
Volume236
DOIs
StatePublished - Jun 1 2017

Fingerprint

Meta-Analysis
Coronary Vessels
Stroke
Calcium
Incidence
Cardiovascular Diseases
PubMed
Longitudinal Studies
Electrocardiography
Odds Ratio
Tomography
Databases
Prospective Studies

Keywords

  • Calcium score
  • Cerebrovascular disease
  • Computed angiography
  • Coronary artery disease
  • Coronary calcification
  • Stroke

PubMed: MeSH publication types

  • Journal Article
  • Meta-Analysis
  • Review
  • Systematic Review

Cite this

Chaikriangkrai, K., Jhun, H. Y., Palamaner Subash Shantha, G., Bin Abdulhak, A., Sigurdsson, G., Nabi, F., ... Chang, S. M. (2017). Coronary artery calcium score as a predictor for incident stroke: Systematic review and meta-analysis. International Journal of Cardiology, 236, 473-477. https://doi.org/10.1016/j.ijcard.2017.01.132

Coronary artery calcium score as a predictor for incident stroke : Systematic review and meta-analysis. / Chaikriangkrai, Kongkiat; Jhun, Hye Yeon; Palamaner Subash Shantha, Ghanshyam; Bin Abdulhak, Aref; Sigurdsson, Gardar; Nabi, Faisal; Mahmarian, John J.; Chang, Su Min.

In: International Journal of Cardiology, Vol. 236, 01.06.2017, p. 473-477.

Research output: Contribution to journalArticle

Chaikriangkrai, K, Jhun, HY, Palamaner Subash Shantha, G, Bin Abdulhak, A, Sigurdsson, G, Nabi, F, Mahmarian, JJ & Chang, SM 2017, 'Coronary artery calcium score as a predictor for incident stroke: Systematic review and meta-analysis', International Journal of Cardiology, vol. 236, pp. 473-477. https://doi.org/10.1016/j.ijcard.2017.01.132
Chaikriangkrai, Kongkiat ; Jhun, Hye Yeon ; Palamaner Subash Shantha, Ghanshyam ; Bin Abdulhak, Aref ; Sigurdsson, Gardar ; Nabi, Faisal ; Mahmarian, John J. ; Chang, Su Min. / Coronary artery calcium score as a predictor for incident stroke : Systematic review and meta-analysis. In: International Journal of Cardiology. 2017 ; Vol. 236. pp. 473-477.
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title = "Coronary artery calcium score as a predictor for incident stroke: Systematic review and meta-analysis",
abstract = "Background Coronary artery calcium score (CACS) is a well-established test for risk stratifying asymptomatic patients for overall cardiovascular or coronary events. However; the prognostic value for incident stroke remains controversial. The objective of this study was to investigate the predictive value of CACS obtained by non-contrast electrocardiogram-gated computed tomography for incident stroke. Methods We searched PubMed, EMBASE, Cochrane databases for prospective longitudinal studies of CACS which reported the incidence of stroke. Incidence of stroke was compared in patients with and without coronary calcification. Results Three studies evaluated 13,262 asymptomatic patients (mean age = 60 years, 50{\%} men) without apparent cardiovascular diseases. During a follow-up of 7.2 years (median 5 years, range 4.4–9.5 years, 95,434 patient-years), the overall pooled incidence of stroke was 0.26{\%}/year. The pooled risk ratio of CACS > 0 for incident stroke was 2.95 (95{\%} CI: 2.18–4.01, p < 0.001) compared to CACS = 0. The heterogeneity among studies was low (I2 = 0{\%}). The pooled incidence rate of stroke categorized by CACS was 0.12{\%}/year for CACS 0, 0.26{\%}/year for CACS 1–99, 0.41{\%}/year for CACS 100–399 and 0.70{\%}/year for CACS ≥ 400. Conclusions In asymptomatic patients without apparent cardiovascular diseases, the incidence of stroke was overall low. The presence and severity of coronary artery calcification were associated with incident stroke over mid-long term follow-up.",
keywords = "Calcium score, Cerebrovascular disease, Computed angiography, Coronary artery disease, Coronary calcification, Stroke",
author = "Kongkiat Chaikriangkrai and Jhun, {Hye Yeon} and {Palamaner Subash Shantha}, Ghanshyam and {Bin Abdulhak}, Aref and Gardar Sigurdsson and Faisal Nabi and Mahmarian, {John J.} and Chang, {Su Min}",
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T1 - Coronary artery calcium score as a predictor for incident stroke

T2 - Systematic review and meta-analysis

AU - Chaikriangkrai, Kongkiat

AU - Jhun, Hye Yeon

AU - Palamaner Subash Shantha, Ghanshyam

AU - Bin Abdulhak, Aref

AU - Sigurdsson, Gardar

AU - Nabi, Faisal

AU - Mahmarian, John J.

AU - Chang, Su Min

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Y1 - 2017/6/1

N2 - Background Coronary artery calcium score (CACS) is a well-established test for risk stratifying asymptomatic patients for overall cardiovascular or coronary events. However; the prognostic value for incident stroke remains controversial. The objective of this study was to investigate the predictive value of CACS obtained by non-contrast electrocardiogram-gated computed tomography for incident stroke. Methods We searched PubMed, EMBASE, Cochrane databases for prospective longitudinal studies of CACS which reported the incidence of stroke. Incidence of stroke was compared in patients with and without coronary calcification. Results Three studies evaluated 13,262 asymptomatic patients (mean age = 60 years, 50% men) without apparent cardiovascular diseases. During a follow-up of 7.2 years (median 5 years, range 4.4–9.5 years, 95,434 patient-years), the overall pooled incidence of stroke was 0.26%/year. The pooled risk ratio of CACS > 0 for incident stroke was 2.95 (95% CI: 2.18–4.01, p < 0.001) compared to CACS = 0. The heterogeneity among studies was low (I2 = 0%). The pooled incidence rate of stroke categorized by CACS was 0.12%/year for CACS 0, 0.26%/year for CACS 1–99, 0.41%/year for CACS 100–399 and 0.70%/year for CACS ≥ 400. Conclusions In asymptomatic patients without apparent cardiovascular diseases, the incidence of stroke was overall low. The presence and severity of coronary artery calcification were associated with incident stroke over mid-long term follow-up.

AB - Background Coronary artery calcium score (CACS) is a well-established test for risk stratifying asymptomatic patients for overall cardiovascular or coronary events. However; the prognostic value for incident stroke remains controversial. The objective of this study was to investigate the predictive value of CACS obtained by non-contrast electrocardiogram-gated computed tomography for incident stroke. Methods We searched PubMed, EMBASE, Cochrane databases for prospective longitudinal studies of CACS which reported the incidence of stroke. Incidence of stroke was compared in patients with and without coronary calcification. Results Three studies evaluated 13,262 asymptomatic patients (mean age = 60 years, 50% men) without apparent cardiovascular diseases. During a follow-up of 7.2 years (median 5 years, range 4.4–9.5 years, 95,434 patient-years), the overall pooled incidence of stroke was 0.26%/year. The pooled risk ratio of CACS > 0 for incident stroke was 2.95 (95% CI: 2.18–4.01, p < 0.001) compared to CACS = 0. The heterogeneity among studies was low (I2 = 0%). The pooled incidence rate of stroke categorized by CACS was 0.12%/year for CACS 0, 0.26%/year for CACS 1–99, 0.41%/year for CACS 100–399 and 0.70%/year for CACS ≥ 400. Conclusions In asymptomatic patients without apparent cardiovascular diseases, the incidence of stroke was overall low. The presence and severity of coronary artery calcification were associated with incident stroke over mid-long term follow-up.

KW - Calcium score

KW - Cerebrovascular disease

KW - Computed angiography

KW - Coronary artery disease

KW - Coronary calcification

KW - Stroke

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