title: Cerebral small artery diseases may be associated with aortic arch calcification in stroke patients.
abstract: OBJECTIVE
  Aortic arch calcification (AoAC) on chest X-rays represents systemic atherosclerosis and it is associated with ischemic cardiovascular diseases. However, the relationship between ischemic stroke and AoAC has yet to be fully elucidated.
  
  
  METHODS
  Patients with acute ischemic stroke who were undergoing chest X-ray, blood, and brain magnetic resonance imaging (MRI) examinations were prospectively studied. The extent of AoAC on chest X-ray was divided into four grades (0-3). Clinical characteristics, biochemical findings, white matter lesions on MRI, and AoAC extent were assessed in each stroke subtype, and the factors associated with AoAC were investigated.
  
  
  RESULTS
  A total of 175 patients (age, 70 ± 13 years; 115 men) were enrolled in the study. According to the Trial of Org 10172 in Acute Stroke Treatment classification with minor modification, 33 patients (19%) had small artery occlusion (SAO), 42 (24%) had large artery atherosclerosis, 49 (28%) had cardioembolism, 24 (14%) had stroke with other determined etiologies, and 27 (17%) had stroke with undetermined etiologies. Compared to other stroke subtypes, the extent of AoAC was independently correlated with SAO (all p<0.05). Age (odds ratio [OR]: 1.14, 95% confidence interval [CI]: 1.08 to 1.19, p<0.001), hypertension, (OR: 3.44, 95% CI: 1.23 to 9.66, p=0.019), diabetes mellitus (OR: 2.19, 95% CI: 0.99 to 4.85, p=0.054), white matter lesions (OR: 1.54, 95% CI: 1.00 to 2.36, p=0.048), and SAO (OR: 1.38, 95% CI: 1.02 to 1.89, p=0.040) were significantly associated with AoAC.
  
  
  CONCLUSIONS
  Age, hypertension, cerebral small artery disease, and possibly diabetes mellitus appear to be closely associated with AoAC in patients with acute ischemic stroke.
authors.affiliation: Department of Neurology, Juntendo University Urayasu Hospital.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ueno
authors.forename: Ayami
authors.initials: A
authors.lastname: Okuzumi
authors.forename: Masao
authors.initials: M
authors.lastname: Watanabe
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Shimada
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yamashiro
authors.forename: Ryota
authors.initials: R
authors.lastname: Tanaka
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Hattori
authors.forename: Takao
authors.initials: T
authors.lastname: Urabe
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000473:pathology*; D002114:Calcinosis / Q000150:complications*; D002561:Cerebrovascular Disorders / Q000150:complications*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000150:complications*