Abstract 13551: Coronary Artery Calcium is Associated with Stenosis Degree and Surface Irregularity of Carotid Artery: Results from the Multi-Ethnic Study of Atherosclerosis (MESA)
Background & Objectives: Overt carotid stenosis and plaque stability are critical determinants of risk for ischemic stroke. Although coronary artery calcium (CAC) is related to carotid intima-media thickness (IMT), the association between CAC and carotid plaque is less well established. To study this we examined data from MESA, a prospective cohort study of subclinical cardiovascular disease in multiethnic participants (N=6814) free of clinical cardiovascular disease at baseline
Methods: The association between coronary artery calcium (CAC) measured by computed tomography and carotid ultrasonographpic evidence of carotid plaque was examined using multiple logistic linear models adjusting for traditional vascular risk factors including age, gender, hypertension, diabetes mellitus, LDL cholesterol (mg/dl), and cigarette smoking status. Both presence of CAC and log-transformed phantom-adjusted Agatston score (limited to subjects with a non-zero value) were used. Carotid stenoses were classified according to degree of stenosis (<25% vs. ≥ 25%) and surface characteristics (no lesion/smooth surface vs. irregular and/or ulcerated). In addition to adjusting for ethnicity, we also developed ethnic specific models to compare the relationship between CAC and carotid disease across the four ethnicities.
Results: Significant carotid stenosis (≥25%) was associated with presence of CAC (OR, 2.53; 95% CI, 2.09-3.07) and log-transformed Agatston score (OR per 1 point increase, 1.27; 95% CI 1.20-1.35). Irregular plaque surface was also associated with presence of CAC (OR, 2.18; 95% CI 1.75-2.70) and log-transformed Agatston score (OR per 1 point 1 increase, 1.18; 95% CI 1.10-1.26). The associations of between CAC and stenosis/stability were not different across ethnic groups.
Conclusion: Both the presence of CAC and log-transferred Agatston score are independently associated with significant carotid stenosis and carotid plaque surface irregularity regardless of ethnicity. More research is needed to determine if subjects with a positive or increased CAC score should be evaluated for presence of carotid disease which may put them at higher risk for ischemic stroke.
- © 2011 by American Heart Association, Inc.