Risk factors for calcification of the vertebrobasilar arteries in cardiovascular patients referred for a head CT, the SMART study - 03/06/21
on behalf of the UCC-SMART-Studygroup
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Autres | 0 |
Graphical abstract |
Highlights |
• | The current study set out to evaluate the risk factors for vertebrobasilar artery calcification in a cohort of cardiovascular patients referred for a head CT, a population for which VBAC burden and risk factors have been poorly investigated. |
• | In this large population of cardiovascular patients referred for a head CT we found that vertebrobasilar artery calcification was present in 25% of the study population. |
• | Presence of vertebrobasilar artery calcification was independently associated with older age, diabetes mellitus, obesity, a low ankle-brachial index, and a large carotid intima-media thickness. |
• | Different pathophysiological mechanisms might contribute to the development of vertebrobasilar artery calcification. |
Abstract |
Background and purpose |
Vertebrobasilar artery calcification (VBAC) has been associated with increased stroke occurrence. Little is known on VBAC risk factors, especially for patients with cardiovascular disease. We aimed to assess risk factors associated with VBAC in a cohort of cardiovascular patients referred for a head computed tomography (CT) scan.
Materials and methods |
All patients who underwent a clinically indicated, unenhanced, thin slice head CT 6 months before or after inclusion in the SMART study were included. CTs were assessed for presence of VBAC (dichotomously). Relative risks of the associations of age, sex, diabetes mellitus (DM), obesity, body mass index, estimated glomerular filtration rate, hypertension, hyperlipidemia, use of lipid lowering medication, smoking status, high sensitivity C-reactive protein, ankle-brachial index (ABI; ≤0.90, ≥1.30, continuous), internal carotid artery stenosis ≥70%, and carotid intima-media thickness (IMT) with VBAC were estimated using Poisson regression analysis with robust standard errors, adjusted for age and sex.
Results |
Of the 471 patients included (57% male, median age 58 [interquartile range 47–63]), 117 (24.8%) showed VBAC. Presence of VBAC was associated with older age (RR per 10 years=1.70 [95%CI 1.46–1.99]), DM (RR=1.45 [95%CI 1.03–2.06]), obesity (RR=1.53 [95%CI 1.10–2.12]), ABI ≤0.90 (RR=1.57 [95%CI 1.02–2.41]), and an increased carotid IMT (RR=2.60 per mm [95%CI 1.20–5.62]). Other measurements were not associated with VBAC.
Conclusions |
We identified several markers associated with VBAC in patients with cardiovascular disease referred for a head CT. Future investigation into the relationship between VBAC and stroke is warranted to determine the potential of VBAC in stroke prevention.
Le texte complet de cet article est disponible en PDF.Keywords : Arterial calcification, Vertebral artery, Basilar artery, Computed tomography, Prevalence, Risk factors
Plan
Vol 48 - N° 4
P. 248-253 - juin 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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