Effect of carotid calcification on the prognosis in patients with ischemic stroke / 中国脑血管病杂志

ABSTRACT

Objective To investigate the relationship between the carotid calcification and the prognosis in patients with ischemic stroke. Methods A total of 522 patients with non-cardiac ischemic stroke registered in the Nanjing Stroke Registry Program (NSRP )from December 2009 to October 2012 were enrolled. All patients underwent head and neck CT angiography (CTA). The original data of CT scan were transmitted into the Siemens workstation. Calcium score measurement was performed using the same reconstruction conditions and Agatston calcium score to measure calcification score. The patients were divided into no (0),mild (0 patients were recorded. The occurrence of primary endpoint events within 2 years after stroke was followed up (ischemic stroke,myocardial infarction,and cardiovascular death). Multivariate COX regression analysis was used to evaluate the effect of carotid calcification score on the primary endpoint events. Kaplan-Meier survival curve was used to analyze the prognosis of patients with different degrees of calcification. Results The median carotid calcification score in 522 patients was 11.9 (quartiles0,107. 9),in which 183 (35. 1%)were in the no calcification group,200 (38. 3%)were in the mild calcification group,and 139 (26. 6%)were in the severe calcification group. A total of 52 patients had a primary endpoint event at follow-up to 2 years. Multivariate COX regression analysis showed that age (HR, 1.034,95%CI 1. 006-1. 062;P=0. 017)and carotid artery calcification (HR,1. 001,95%CI 1. 000-1.001;P=0. 037)were the independent risk factors for the prognosis of ischemic stroke. Kaplan-Meier analysis showed that the 2-year cumulative incidences of the primary endpoint events were 5. 5%(n=10),9. 7%(n=16 ),and 15. 0%(n = 26 ),respectively in the no,mild and severe calcification groups. The incidence of endpoint event of the severe calcification group was significantly higher than that of the no calcification group (HR,1.612,95%CI 1.106-2.350;P=0.013). Conclusion Carotid calcification may be an important influencing factor for the prognosis in patients with ischemic stroke.