Coronary artery calcium is associated with degree of stenosis and surface irregularity of carotid artery.
OBJECTIVE
Carotid stenosis and plaque stability are critical determinants of risk for ischemic stroke. The aim of this study is to elucidate the association of CAC with carotid stenosis and plaque characteristics.


METHODS
We examined data from the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective cohort study of subclinical cardiovascular disease in multiethnic participants (N = 6814). The association between CAC measured by computed tomography and carotid ultrasonography of carotid plaque was examined using multiple logistic linear models adjusting for traditional vascular risk factors including ethnicity. We also developed ethnic specific models to compare the relationship between CAC and carotid disease across the four ethnicities.


RESULTS
Significant carotid stenosis was associated with the presence of CAC (OR 1.73; 95% CI, 1.20-2.49) and log-transformed Agatston score (OR per 1 point increase, 1.18; 95% CI 1.04-1.35). Overt carotid stenosis was also associated with the presence of CAC (OR, 2.34; 95% CI, 1.93-2.83) and log-transformed Agatston score (OR per 1 point increase, 1.53; 95% CI 1.38-1.69). Irregular plaque surface was associated with the presence of CAC (OR, 1.87; 95% CI 1.50-2.32) and the log-transformed Agatston score (OR per 1 point 1 increase, 1.31; 95% CI 1.16-1.48). Associations between CAC and stenosis/stability were not different across ethnicities.


CONCLUSIONS
Both the presence of CAC and log-transferred Agatston score are independently associated with significant/overt carotid stenosis and carotid plaque surface irregularity regardless of ethnicity. The subjects with a positive or increased CAC score are more likely to have carotid disease potentially increasing their risk for future ischemic stroke.
Department of Neurology, Soonchunhyang University School of Medicine, Seoul, Republic of Korea. kblee@schmc.ac.kr
Kyung Bok
KB
Lee
Matthew J
MJ
Budoff
Anna
A
Zavodni
Joseph F
JF
Polak
J
J
Jeffrey Carr
Gregory L
GL
Burke
David M
DM
Herrington
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000706:statistics & numerical data; D002545:Brain Ischemia / Q000208:ethnology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology*; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000208:ethnology / Q000473:pathology; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000208:ethnology; D018450:Disease Progression; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000208:ethnology; D018608:Ultrasonography, Doppler; D014481:United States / Q000453:epidemiology; D061205:Vascular Calcification / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data