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Risk factors for calcification of the vertebrobasilar arteries in cardiovascular patients referred for a head CT, the SMART study - 26/03/20

Doi : 10.1016/j.neurad.2020.02.004 
Tim C. van den Beukel a, Carlo Lucci a, Jeroen Hendrikse a, Wilko Spiering b, Huiberdina L. Koek c, Mirjam I. Geerlings d, Pim A. de Jong a,

on behalf of the UCC-SMART-Studygroup

a Department of Radiology, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands 
b Department of Vascular Medicine, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands 
c Department of Geriatrics, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands 
d Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands 

Corresponding author. University Medical Center Utrecht, Department of Radiology, P.O. Box 85500, 3508 ,GA, Utrecht, The Netherlands.University Medical Center Utrecht, Department of RadiologyP.O. Box 85500GA, Utrecht3508The Netherlands
En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Thursday 26 March 2020
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Graphical abstract




El texto completo de este artículo está disponible en PDF.

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.

El texto completo de este artículo está disponible en PDF.

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.

El texto completo de este artículo está disponible en PDF.

Keywords : Arterial calcification, Vertebral artery, Basilar artery, Computed tomography, Prevalence, Risk factors


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