TY - JOUR
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
N1 - Publisher Copyright:
© 2017 Elsevier B.V.
PY - 2017/6/1
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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U2 - 10.1016/j.ijcard.2017.01.132
DO - 10.1016/j.ijcard.2017.01.132
M3 - Article
C2 - 28202259
AN - SCOPUS:85011949063
SN - 0167-5273
VL - 236
SP - 473
EP - 477
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -
