Coronary Artery Calcium as a predictor of CVA
Although coronary heart disease has a significant and well-established
association with ischemic stroke development, the association between
CAC and stroke development was not recognized until recently. Initially,
analysis of the Rotterdam study failed to show improved CVA prediction
by CAC scoring, and analysis of the MESA study had shown that intimal
media thickness (IMT), but not CAC, was a significant predictor of
stroke in a multivariate model including both
variables.34,35 The findings in the MESA cohort had
corroborated earlier findings, which had shown intimal medial thickness
(of the common carotid) to be a more specific marker of stroke
risk.36 A more recent analysis was that of the Heinz
Nixdorf Recall (HNR) cohort, which showed that CAC could be a
particularly useful measure of stroke risk in younger
demographics.37
A more recent analysis of the MESA trial had shown CAC to be a
statistically significant predictor of stroke risk; however, unlike the
analysis of the HNR cohort, CAC scoring was more predictive in the
elderly rather than in the young.38