title: Calcified carotid artery atheroma and stroke: a systematic review.
abstract: BACKGROUND
  Calcified carotid artery atheroma (CCAA) and its identification on panoramic radiographs have been advocated as a predictor of a cerebrovascular accident (CVA).
  
  
  METHODS
  The authors conducted an electronic search using 11 databases to evaluate the evidence from the literature that links CCAA detection on panoramic radiographs and the precipitation of CVAs among those people. They used the Reporting Recommendations for Tumor Marker Prognostic Studies (REMARK) checklist to perform this systematic review.
  
  
  RESULTS
  One study of the 54 studies the authors identified satisfied the REMARK criteria in which CCAA was associated with a negligible increased risk of stroke (95 percent confidence interval, 0 to 0.04 percent) in the population studied.
  
  
  CONCLUSIONS
  This systematic review suggests the data supporting the hypothesis that radiographically detectable CCAA is associated with an increased risk of stroke are incomplete and inconclusive. Further research is needed, as clinical guidelines for risk prediction using panoramic radiographs cannot be established on the basis of the current evidence.
authors.affiliation: Diagnostic Sciences, University of Medicine and Dentistry of New Jersey, New Jersey Dental School, Newark, NJ 07101, USA. m.mupparapu@umdnj.edu
authors.forename: Muralidhar
authors.initials: M
authors.lastname: Mupparapu
authors.forename: Irene H
authors.initials: IH
authors.lastname: Kim
mesh_terms: D050197:Atherosclerosis / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D011862:Radiography, Panoramic; D012307:Risk Factors; D020521:Stroke / Q000517:prevention & control*