title: Prevalence of calcified carotid artery atheromas on panoramic images of older men with gout: a descriptive retrospective study.
abstract: OBJECTIVE
  Given the enhanced risk of ischaemic stroke resulting from the direct effects of hyperuricaemia on vascular plaque formation seen among older males with gout, we sought to determine the prevalence of calcified carotid artery atheromas (CCAAs) on their panoramic images (PIs).
  
  
  METHODS
  Medical record librarians identified all male patients over 45 years, who had a diagnosis of gout and a PI incidentally obtained between 2000 and 2015. The prevalence rate of CCAA on technically appropriate images was determined, as were these patients' atherogenic risk profiles including: age, body mass index, hypertension and dyslipidaemia. Comparisons of atherogenic risk factors were made between this cohort and those without CCAA.
  
  
  RESULTS
  Of the 531 patients with gout, 163 patients were adjudicated to be CCAA+ (the panoramic image demonstrates a calcified carotid artery atheroma). Logistic regression analysis demonstrated that a comorbid diagnosis of diabetes mellitus or dyslipidaemia, or advancing age was determinant in differentiating patients who were CCAA+ vs those who were CCAA- (the panoramic image does not demonstrate a calcified carotid artery atheroma).
  
  
  CONCLUSIONS
  CCAAs often herald an ischaemic stroke and may be seen on the PIs of patients with gout, especially those with increased age, dyslipidaemia or diabetes. Thus, dentists must be uniquely vigilant in detecting these lesions when evaluating the images of all patients with gout, especially those with additional positive risk factors.
authors.affiliation: 1 Graduate Medical Education Service, Veterans Affairs, Greater Los Angeles Healthcare System, Los Angeles, CA, USA.|2 Oral and Maxillofacial Surgery Service at the Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA.|3 UCLA Dental School, Los Angeles, CA, USA.
authors.forename: Arthur H
authors.initials: AH
authors.lastname: Friedlander
authors.affiliation: 4 Dental Service, Veterans Affairs, Greater Los Angeles Healthcare System.
authors.forename: Lindsay L
authors.initials: LL
authors.lastname: Graves
authors.affiliation: 5 Research Service, School of Medicine, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Shannon G
authors.initials: SG
authors.lastname: Grabich
authors.affiliation: 4 Dental Service, Veterans Affairs, Greater Los Angeles Healthcare System.
authors.forename: Nona
authors.initials: N
authors.lastname: Aghazadehsanai
authors.affiliation: 3 UCLA Dental School, Los Angeles, CA, USA.|4 Dental Service, Veterans Affairs, Greater Los Angeles Healthcare System.
authors.forename: Tina I
authors.initials: TI
authors.lastname: Chang
mesh_terms: D000368:Aged; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006073:Gout / Q000150:complications*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: atherosclerosis; carotid artery; gout; panoramic images