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

doi:10.1016/j.ijcard.2017.01.132

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Coronary artery calcium score as a predictor for incident stroke: Systematic review and meta-analysis

Journal article

Peer reviewed

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 and Su Min Chang

International journal of cardiology, Vol.236, pp.473-477

06/01/2017

DOI: 10.1016/j.ijcard.2017.01.132

PMID: 28202259

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Abstract

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. 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. Three studies evaluated 13,262 asymptomatic patients (mean age=60years, 50% men) without apparent cardiovascular diseases. During a follow-up of 7.2years (median 5years, range 4.4–9.5years, 95,434patient-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. 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.

Stroke

Computed angiography

Coronary calcification

Calcium score

Coronary artery disease

Cerebrovascular disease

Details

Title: Subtitle: Coronary artery calcium score as a predictor for incident stroke: Systematic review and meta-analysis
Creators: Kongkiat Chaikriangkrai - University of Iowa Hospital: Heart and Vascular Center, United States
Hye Yeon Jhun - Department of Medicine, University of Kansas Medical Center, United States
Ghanshyam Palamaner Subash Shantha - University of Iowa Hospital: Heart and Vascular Center, United States
Aref Bin Abdulhak - University of Iowa Hospital: Heart and Vascular Center, United States
Gardar Sigurdsson - University of Iowa Hospital: Heart and Vascular Center, United States
Faisal Nabi - Houston Methodist DeBakey Heart & Vascular Center, United States
John J Mahmarian - Houston Methodist DeBakey Heart & Vascular Center, United States
Su Min Chang - Houston Methodist DeBakey Heart & Vascular Center, United States
Resource Type: Journal article
Publication Details: International journal of cardiology, Vol.236, pp.473-477
DOI: 10.1016/j.ijcard.2017.01.132
PMID: 28202259
NLM abbreviation: Int J Cardiol
ISSN: 0167-5273
eISSN: 1874-1754
Publisher: Elsevier B.V
Language: English
Date published: 06/01/2017
Academic Unit: Gastroenterology and Hepatology; Cardiovascular Medicine; Internal Medicine
Record Identifier: 9984094569902771

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