Carotid artery calcification as a predictor of systemic vascular events

Abstract

Background: Coronary calcification is a well-known predictor of coronary events, yet the impact of carotid artery calcification on systemic vascular events (e.g., cerebral ischemic, coronary, and peripheral artery events) remains unclear. The aim of this study was to determine whether carotid calcification can be used to predict systemic vascular events.

Methods: This single-center, retrospective cohort study included 194 patients who had a history of vascular disease, including carotid stenosis or occlusion, coronary artery disease, valvular heart disease, ischemic stroke, or transient ischemic attack. We collected data pertaining to risk factors and laboratory parameters. Calcification of the carotid arteries was assessed via whole-body computed tomography, and the modified carotid Agatston calcium score (CCS) was determined. Participants were divided into two CCS groups according to the cut-off value determined via receiver operating characteristic curve analysis; high CCS ≥ 126 and low CCS < 126. Coronary, ischemic cerebrovascular, and peripheral vascular events were recorded over a 5-year follow-up period, and their incidence was compared between the groups using Cox proportional hazards regression analysis.

Results: Older age, hypertension, and chronic kidney disease had a significant positive impact on the CCS. Systemic vascular events (hazard ratio [HR]: 2.70, CI: 1.07-6.79, p = 0.022), coronary events (HR: 4.29, CI: 0.87-21.1, p = 0.045), and peripheral vascular events (p = 0.032) were significantly more frequent in the high versus low CCS group.

Conclusion: The CCS may be a useful tool for predicting future systemic vascular events, including those related to coronary and peripheral artery diseases.

Keywords: atherosclerosis; calcification; carotid artery disease; computed tomography (CT); coronary artery disease (CAD); peripheral artery disease (PAD).