Precranial artery calcification burden: a potential indicator of the clinical outcome of reperfusion in patients with acute large artery occlusion

Author:

Cai Xiaofeng1ORCID,Zhou Dengfeng2,Wang Peng1ORCID,Zhang Zheyu3,Fan Yongmei1,Lin Longting4,Geng Yu1,Mossa-Basha Mahmud5,Zhu Chengcheng5,Zhang Sheng1

Affiliation:

1. Centre for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China

2. Key Laboratory of Bioorganic Synthesis of Zhejiang Province, College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, Zhejiang, China

3. Department of Neurology, Ningbo First Hospital, Ningbo, China

4. School of Medicine and Public Health, University of Newcastle, Australia

5. Department of Radiology, University of Washington, Seattle, WA, United States

Abstract

Objective With mechanical thrombectomy (MT), we investigated the prognostic importance of aortic arch calcification (AoAC) and carotid sinus calcification (CaSC) for symptomatic intracerebral hemorrhage (sICH) and poor outcome in acute large artery occlusion (LAO). Methods In this retrospective observational study, we calculated pre-cranial artery calcification burden (PACB) scores (burden score of AoAC and CaSC) using the AoAC grading scale score plus Woodcock visual score. The outcome measure was sICH per the European Cooperative Acute Stroke Study III definition. A 3-month modified Rankin scale score 3–6 was designated as poor outcome. Results Compared with patients who had PACB <3, those with PACB ≥3 showed substantially higher risks of sICH (odds ratio [OR] = 2.567, 95% confidence interval [CI] = 1.187–5.550) and poor outcome (OR = 4.777, 95% CI = 1.659–13.756). According to receiver operating characteristic (ROC) curves, adding PACB to the regression model enhanced the predictive value for poor outcome (area under the ROC curve [AUC]: 0.718 vs. 0.519, Z = 2.340) and in patients receiving MT (AUC: 0.714 vs. 0.584, Z = 2.021), independently. Conclusions Factors related to PACB were consistent with common risk factors of systemic atherosclerosis. Low PACB scores indicated better prognosis. In patients with LAO following MT, PACB was useful in predicting sICH and poor clinical outcome.

Funder

Key project of the Department of Science and Technology of Zhejiang Province

Medical Health Science and Technology Project of the Zhejiang Provincial Health Commission

Zhejiang Traditional Chinese Medicine Science and Technology Program

Zhejiang Provincial Natural Science Foundation of China

Publisher

SAGE Publications

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