title: Cerebral artery calcification in patients with acute cerebrovascular diseases: determinants and long-term clinical outcome.
abstract: OBJECTIVE
  Coronary artery calcium is an independent predictor of all-cause mortality. We sought to examine the determinants of intracranial cerebral artery calcification (CAC) and its association with long-term outcome in a large prospective cohort of stroke patients.
  
  
  METHODS
  Consecutive patients hospitalized because of acute stroke (ischaemic and intracerebral hemorrhage) or TIA throughout a large medical center were systematically assessed and followed up for 1 year. Intracranial CAC was assessed from baseline brain CT blinded to clinical data. Patients were categorized to no, mild, and severe CAC according to their total CAC score. Determinants of CAC were studied with logistic regression analysis. Risk of death, Barthel Index ≤ 60 or death and living in a nursing facility or death were assessed.
  
  
  RESULTS
  Amongst 1049 patients (mean age: 70 ± 13 years, 59% males) CAC was present in 727 (69%) patients. The main determinants of CAC were increasing age (OR 1.4, 95% CI 1.3-1.6, per 5 years), diabetes (OR: 2.1, 1.4-3.0), smoking (1.4, 1.0-2.2), hypertension (1.4, 1.0-2.1), and prior coronary heart disease (1.9, 1.3-2.9). CAC was associated with mortality and poor outcome amongst patients with ischaemic stroke; however, after adjusting for age and stroke severity, no significant association was observed. In patients with intracerebral hemorrhage, outcomes were not related to CAC.
  
  
  CONCLUSIONS
  Intracranial CAC is highly prevalent in patients with acute stroke and its main determinants are older age, diabetes, smoking, hypertension, and prior coronary heart disease. Associations between CAC and mortality or poor functional outcome in the first year after ischaemic stroke are mainly age- and stroke severity-driven.
authors.affiliation: Tel Aviv University, Tel Aviv, Israel.
authors.forename: S
authors.initials: S
authors.lastname: Koton
authors.forename: V
authors.initials: V
authors.lastname: Tashlykov
authors.forename: Y
authors.initials: Y
authors.lastname: Schwammenthal
authors.forename: N
authors.initials: N
authors.lastname: Molshatzki
authors.forename: O
authors.initials: O
authors.lastname: Merzeliak
authors.forename: R
authors.initials: R
authors.lastname: Tsabari
authors.forename: D
authors.initials: D
authors.lastname: Tanne
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000175:diagnosis* / Q000209:etiology*; D002536:Cerebral Arteries / Q000473:pathology*; D002561:Cerebrovascular Disorders / Q000145:classification / Q000150:complications* / Q000453:epidemiology; D015331:Cohort Studies; D015981:Epidemiologic Factors; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012307:Risk Factors; D012720:Severity of Illness Index