title: Presence of intracranial artery calcification is associated with mortality and vascular events in patients with ischemic stroke after hospital discharge: a cohort study.
abstract: OBJECTIVE
  Although intracranial artery calcification (IAC) has been reported to be a risk factor for ischemic stroke, the prognostic implications of IAC in stroke outcome are unknown. The purpose of this study was to determine the association between IAC and risk of vascular events and death in patients with stroke after hospital discharge.
  
  
  METHODS
  All patients with ischemic stroke over a 1-year period were included (n=302). IAC, assessed by multidetector CT, was defined as hyperdense foci (peak density>130 Hounsfield units) and assessed in the 7 major cerebral arteries. The IAC scores ranged from 0 (no calcification) to 7. Follow-up information on major clinical events (including fatal or nonfatal ischemic stroke, cardiac and peripheral artery events, and all-cause death) was obtained by means of a structured phone interview.
  
  
  RESULTS
  IAC was present in 260 patients (83%). With a mean follow-up of 773±223 days, 88 major clinical events occurred in 67 patients (22%): 45 new ischemic vascular events (ischemic stroke: n=22; cardiac event: n=15; peripheral artery event: n=8) and 43 deaths from any cause. Patients with the highest IAC scores had significantly higher rates of death and vascular events than those with the lowest IAC scores (log rank test, P=0.029). In the Cox proportional hazards regression model, the IAC score was significantly associated with major clinical events (hazard ratio, 1.34; 95% CI, 1.11-1.61; P=0.002).
  
  
  CONCLUSIONS
  In patients with ischemic stroke, IAC detection may constitute a simple marker of a high risk of future major clinical events.
authors.affiliation: Service de Neurologie, CHU Amiens, France, Place Victor Pauchet, F-80054 Amiens Cedex 1, France. bugnicourt.jean-marc@chu-amiens.fr
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Bugnicourt
authors.forename: Claire
authors.initials: C
authors.lastname: Leclercq
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Chillon
authors.forename: Momar
authors.initials: M
authors.lastname: Diouf
authors.forename: Hervé
authors.initials: H
authors.lastname: Deramond
authors.forename: Sandrine
authors.initials: S
authors.lastname: Canaple
authors.forename: Chantal
authors.initials: C
authors.lastname: Lamy
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Massy
authors.forename: Olivier
authors.initials: O
authors.lastname: Godefroy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000401:mortality; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000401:mortality; D002536:Cerebral Arteries / Q000000981:diagnostic imaging*; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011379:Prognosis; D011859:Radiography; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging* / Q000401:mortality