Abstract 9311: Association of Traumatic Brain Injury with Subclinical Atherosclerosis Measured by Coronary Artery Calcium

Abstract

Background: Traumatic brain injury (TBI) is a devastating condition resulted in cerebral edema and ischemia. Pre-clinical studies have documented production of cytokine, growth factor and inflammatory biomarkers following TBI. This study investigates the relation of TBI with subclinical atherosclerosis measured by coronary artery calcium (CAC).

Method: This nested case-control study consists of 543 Veterans (age 59±10 years, 100% male) with and without TBI who underwent CAC scanning. VA electronic medical records from veterans were used to evaluate medical and psychological diagnoses, procedures, and risk factors. Logistic regression analysis was employed to assess the association of TBI with CAC. CAC was defined as 0, 1-100, 101-400 and 400+.

Results: TBI was more prevalent with the presence and severity of CAC (p0 was significantly higher in individuals with TBI as compared to those without TBI (81.2% vs. 60.1%, p=0.0001). After adjustment for age and conventional risk factors, the relative risk of CAC>0 was 176% higher in TBI as compared without TBI (RR: 2.76 (95%CI 1.5-4.9, p=0.001). Similarly, the median CAC was higher in TBI as compared to normal subjects (129A Agatston score vs. 52A Agatston score, p=0.001). After adjustment of risk factors, the relative risk of CAC 1-100, 101-400 and 400+ was 2.22(95%CI 1.03-4.78, p=0.04), 2.98(95%CI 1.49-5.97,p=0.002) and 3.26 (95%CI 1.74-6.14, p=0.001) in individuals with TBI as compared to their matched subjects without TBI, respectively.

Conclusion: TBI is independently associated with the presence and severity of subclinical atherosclerosis measured by CAC. This highlights the importance of cardiovascular risk stratification in subjects with TBI.