AUTHOR=de Araújo Ana Luíza Vieira , Santos Raul D. , Bittencourt Marcio Sommer , Dantas Roberto Nery , Oshiro Carlos André , Nomura Cesar Higa , Bor-Seng-Shu Edson , Oliveira Marcelo de Lima , Leite Claudia da Costa , Martin Maria da Graça Morais , Alves Maramelia Miranda , Silva Gisele Sampaio , Silva Victor Marinho , Conforto Adriana Bastos 

TITLE=Ischemic stroke caused by large-artery atherosclerosis: a red flag for subclinical coronary artery disease

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1082275

DOI=10.3389/fneur.2023.1082275

ISSN=1664-2295

ABSTRACT=Background: The coronary calcium score (CAC) measured on chest computerized tomography is a risk marker of cardiac events and mortality. We compared CAC scores in two multiethnic groups without symptomatic coronary artery disease: subjects in the chronic phase after stroke or transient ischemic attack and at least one symptomatic stenosis ≥ 50% in the carotid or vertebrobasilar territories (Groupathero) and a control group (Groupcontrol).
Methods: In this cross-sectional study, Groupathero included two subgroups: GroupExtraorIntra, with stenoses in either cervical or intracranial arteries; GroupExtra&Intra, with stenoses in at least one cervical and one intracranial artery. Groupcontrol had no history of prior stroke/transient ischemic attacks and no stenoses ≥ 50% in cervical or intracranial arteries. Age and sex were comparable in all groups. Frequencies of CAC ≥ 100 and CAC > 0 were compared between Groupathero and Groupcontrol, as well as between GroupExtraorIntr, GroupExtra&Intra and Groupcontrol, with bivariate logistic regressions. Multivariate analyses were also performed. 
Results: A total of 120 patients were included: 80 in Groupathero and 40 in Groupcontrol. CAC > 0 was significantly more frequent in Groupathero (85%) than Groupcontrol (OR, 4.19; 1.74-10.07; p = 0.001). Rates of CAC ≥ 100 were not significantly different between Groupathero and Groupcontrol but were significantly greater in GroupExtra&Intra (n=13) when compared to Groupcontrol (OR 4.67; 1.21-18.04; p = 0.025).  In multivariate adjusted analyses, “Groupathero” and “GroupExtra&Intra” were significantly associated with CAC. 
Conclusions:  The frequency of coronary calcification was higher in subjects with stroke caused by large artery atherosclerosis than in controls.