Burden of intracranial artery calcification in white patients with ischemic stroke
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Burden of intracranial artery calcification in white patients with ischemic stroke. / Berghout, Bernhard P.; Camarasa, Robin Y.R.; Van Dam-Nolen, Dianne H.K.; van der Lugt, Aad; de Bruijne, Marleen; Koudstaal, Peter J.; Ikram, M. Kamran; Bos, Daniel.
In: European Stroke Journal, 2024.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Burden of intracranial artery calcification in white patients with ischemic stroke
AU - Berghout, Bernhard P.
AU - Camarasa, Robin Y.R.
AU - Van Dam-Nolen, Dianne H.K.
AU - van der Lugt, Aad
AU - de Bruijne, Marleen
AU - Koudstaal, Peter J.
AU - Ikram, M. Kamran
AU - Bos, Daniel
N1 - Publisher Copyright: © European Stroke Organisation 2024.
PY - 2024
Y1 - 2024
N2 - Introduction: The diagnostic workup of stroke doesn’t identify an underlying cause in two-fifths of ischemic strokes. Intracranial arteriosclerosis is acknowledged as a cause of stroke in Asian and Black populations, but is underappreciated as such in whites. We explored the burden of Intracranial Artery Calcification (IAC), a marker of intracranial arteriosclerosis, as a potential cause of stroke among white patients with recent ischemic stroke or TIA. Patients and methods: Between December 2005 and October 2010, 943 patients (mean age 63.8 (SD ± 14.0) years, 47.9% female) were recruited, of whom 561 had ischemic stroke and 382 a TIA. CT-angiography was conducted according to stroke analysis protocols. The burden of IAC was quantified on these images, whereafter we assessed the presence of IAC per TOAST etiology underlying the stroke and assessed associations between IAC burden, symptom severity, and short-term functional outcome. Results: IAC was present in 62.4% of patients. Furthermore, IAC was seen in 84.8% of atherosclerotic strokes, and also in the majority of strokes with an undetermined etiology (58.5%). Additionally, patients with larger IAC burden presented with heavier symptoms (adjusted OR 1.56 (95% CI [1.06–2.29]), but there was no difference in short-term functional outcome (1.14 [0.80–1.61]). Conclusion: IAC is seen in the majority of white ischemic stroke patients, aligning with findings from patient studies in other ethnicities. Furthermore, over half of patients with a stroke of undetermined etiology presented with IAC. Assessing IAC burden may help identify the cause in ischemic stroke of undetermined etiology, and could offer important prognostic information.
AB - Introduction: The diagnostic workup of stroke doesn’t identify an underlying cause in two-fifths of ischemic strokes. Intracranial arteriosclerosis is acknowledged as a cause of stroke in Asian and Black populations, but is underappreciated as such in whites. We explored the burden of Intracranial Artery Calcification (IAC), a marker of intracranial arteriosclerosis, as a potential cause of stroke among white patients with recent ischemic stroke or TIA. Patients and methods: Between December 2005 and October 2010, 943 patients (mean age 63.8 (SD ± 14.0) years, 47.9% female) were recruited, of whom 561 had ischemic stroke and 382 a TIA. CT-angiography was conducted according to stroke analysis protocols. The burden of IAC was quantified on these images, whereafter we assessed the presence of IAC per TOAST etiology underlying the stroke and assessed associations between IAC burden, symptom severity, and short-term functional outcome. Results: IAC was present in 62.4% of patients. Furthermore, IAC was seen in 84.8% of atherosclerotic strokes, and also in the majority of strokes with an undetermined etiology (58.5%). Additionally, patients with larger IAC burden presented with heavier symptoms (adjusted OR 1.56 (95% CI [1.06–2.29]), but there was no difference in short-term functional outcome (1.14 [0.80–1.61]). Conclusion: IAC is seen in the majority of white ischemic stroke patients, aligning with findings from patient studies in other ethnicities. Furthermore, over half of patients with a stroke of undetermined etiology presented with IAC. Assessing IAC burden may help identify the cause in ischemic stroke of undetermined etiology, and could offer important prognostic information.
KW - arteriosclerosis
KW - intracranial arterial diseases
KW - large-artery atherosclerosis
KW - Stroke
KW - vascular calcification
UR - http://www.scopus.com/inward/record.url?scp=85188295415&partnerID=8YFLogxK
U2 - 10.1177/23969873241239787
DO - 10.1177/23969873241239787
M3 - Journal article
C2 - 38506452
AN - SCOPUS:85188295415
JO - European Stroke Journal
JF - European Stroke Journal
SN - 2396-9873
ER -
ID: 387837194