title: Intracranial arterial calcification can predict early vascular events after acute ischemic stroke.
abstract: BACKGROUND
  Intracranial arterial calcification (IAC) is an evidence of advanced atherosclerosis. This study was aimed to investigate whether IAC predicts early vascular events (EVEs) during acute period of ischemic stroke.
  
  
  METHODS
  We prospectively enrolled consecutive patients with acute ischemic stroke and transient ischemic attack within 48 hours from January 2005 to October 2012. Three IAC categories were defined according to the total IAC score as follows: no IAC (0 point), mild IAC (1-2 points), and severe IAC (≥3 points). EVEs included early progression/recurrence of stroke, coronary events, and vascular deaths within 2 weeks from stroke onset. We used multivariable Cox regression analyses to determine the effect of IAC on EVE.
  
  
  RESULTS
  In the trend analysis of 1017 total patients, there were significant trends of increased IAC toward higher total EVEs (10.5% versus 13.8% versus 21.2%, P < .001). Severe IAC was related to increased rate of early progression/recurrence (hazard ratio [HR] 2.00; 95% confidence interval [CI] 1.07-3.71, P = .029) and coronary events (HR 3.51; 95% CI 1.00-12.31, P = .050) but did not show an association for mortality (HR .54; 95% CI .19-1.53, P = .224). Increased IAC was also related to a poor functional outcome after 3 months (odds ratio 2.23; 95% CI 1.38-3.59).
  
  
  CONCLUSIONS
  IAC was significantly associated with increased early progression/recurrence of stroke and coronary events during acute period of ischemic stroke. IAC on the initial brain computed tomography would be used as a predictor for recurrent vascular events after acute ischemic stroke before further angiographic evaluation.
authors.affiliation: Department of Neurology, Soonchunhyang University, College of Medicine, Seoul, Korea.
authors.forename: Jung-Gon
authors.initials: JG
authors.lastname: Lee
authors.affiliation: Department of Neurology, Soonchunhyang University, College of Medicine, Seoul, Korea. Electronic address: kblee@schmc.ac.kr.
authors.forename: Kyung-Bok
authors.initials: KB
authors.lastname: Lee
authors.affiliation: Department of Neurology, Soonchunhyang University, College of Medicine, Seoul, Korea.
authors.forename: Hakjae
authors.initials: H
authors.lastname: Roh
authors.affiliation: Department of Neurology, Soonchunhyang University, College of Medicine, Seoul, Korea.
authors.forename: Moo-Young
authors.initials: MY
authors.lastname: Ahn
authors.affiliation: Department of Neurology, Seoul National University Bundang hospital, Seongnam, Korea.
authors.forename: Hee-Joon
authors.initials: HJ
authors.lastname: Bae
authors.affiliation: Department of Biostatistics, Soonchunhyang University, College of Medicine, Seoul, Korea.
authors.forename: Ji-Sung
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hee-Yeon
authors.initials: HY
authors.lastname: Woo
authors.affiliation: Department of Neurology, Soonchunhyang University, College of Medicine, Seoul, Korea.
authors.forename: Hye-Won
authors.initials: HW
authors.lastname: Hwang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D002539:Cerebral Arterial Diseases / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D061205:Vascular Calcification / Q000150:complications* / Q000175:diagnosis / Q000401:mortality
keywords: Vascular calcification; acute ischemic stroke; cerebral arteries; recurrent stroke