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