Abstract W P122: Cerebral Small Vessel Diseases May be Associated With Aortic Arch Calcification in Patients With Acute Stroke

Abstract

Background: Aortic arch calcification (AoAC) on chest X-ray represents systemic atherosclerosis and is associated with ischemic cardiovascular diseases. However, the relationship between ischemic stroke and AoAC has yet to be fully elucidated. This study focused on the relationship between AoAC and stroke subtype, and the factors linked with AoAC in patients with acute ischemic stroke were investigated. Methods: This study prospectively enrolled patients with acute ischemic stroke who were undergoing chest X-ray, blood examinations, and brain MRI. Classification of ischemic stroke subtype was based on the Trial of Org 10172 in Acute Stroke Treatment classification with minor modification. The extent of AoAC on chest X-ray was divided into four grades: no visible calcification (grade 0); small spots or a single thin area of calcification (grade 1); one or more areas of thick calcification (grade 2); and circumferential calcification (grade 3). Clinical characteristics, biochemical findings, and extent of AoAC in each stroke subtype were assessed. Results: 175 patients (age, 70 ± 13 years; 115 males) were enrolled in the study. 33 patients (19%) had small artery occlusion (SAO), 42 (24%) had large artery atherosclerosis, 49 (28%) had cardioembolism, 24 (14%) had stroke with other determined etiologies, and 27 (17%) had stroke with undetermined etiologies. Among stroke subtypes, the extent of AoAC was the highest in patients with SAO (p=0.036). Multinomial logistic regression analysis showed that the extent of AoAC was negatively correlated to other stroke subtypes compared to SAO (all p<0.05). Age (OR: 1.14; 95% CI: 1.08 to 1.19; p<0.001), hypertension, (OR: 3.44; 95% CI: 1.23 to 9.66; p=0.019), diabetes mellitus (OR: 2.19; 95% CI: 0.99 to 4.85; p=0.054), white matter lesions (OR: 1.54; 95% CI: 1.00 to 2.36; p=0.048), and SAO (OR: 1.38; 95% CI: 1.02 to 1.89; p=0.040) were significantly associated with high-grade AoAC. Conclusions: SAO was closely associated with AoAC. Age, hypertension, and possibly diabetes mellitus can increase the risk of cerebral small artery diseases including SAO and white matter lesions, and aortic arch calcification in patients with acute ischemic stroke.