Abstract
BackgroundIn odontology, panoramic radiographs (PRs) are regularly performed. PRs depict the teeth and jaws as well as carotid artery calcifications (CACs). Patients with CACs on PRs have an increased risk of vascular events compared to healthy controls without CACs, but this association is often caused by more vascular events and risk factors at baseline. However, the risk of vascular events has only been analyzed based on the presence of CACs, and not their shape. Thus, this study determined if the shape of CACs in PRs affects the risk of future vascular events.MethodsThe study cohort included 117 consecutive patients with CACs in PRs and 121 age-matched controls without CACs. CAC shape in PRs was dichotomized into bilateral vessel-outlining CACs and other CAC shapes. Participants were followed prospectively for an endpoint of vascular events including myocardial infarction, stroke, and vascular death.ResultsPatients with bilateral vessel-outlining CACs had more previous vascular events than those with other CAC shapes and the healthy controls (p < 0.001, χ2). The mean follow-up duration was 9.5 years. The endpoint was reached in 83 people. Patients with bilateral vessel-outlining CACs had a higher annual risk of vascular events (7.0%) than those with other CAC shapes (4.4%) and the controls (2.6%) (p < 0.001). In multivariate analysis, bilateral vessel-outlining CACs (hazard ratio: 2.2, 95% confidence interval: 1.1–4.5) were independent risk markers for the endpoint.ConclusionsFindings of bilateral vessel-outlining CACs in PRs are independent risk markers for future vascular events.
Highlights
In odontology, panoramic radiographs (PRs) are regularly performed
The aim of this study was to determine if the shape of CACs in PRs affects the risk of future vascular events
83 patients reached the primary endpoint with an average annual risk of 3.7%
Summary
Panoramic radiographs (PRs) are regularly performed. PRs depict the teeth and jaws as well as carotid artery calcifications (CACs). Atherosclerosis is the main cause of vascular events [1]. Because it is a slow, progressive disease, there is opportunity to introduce preventive treatments in targeted subgroups with high vascular risk [2]. One strategy for distinguishing subgroups with high vascular risk is the identification of atherosclerotic carotid plaques. These plaques, even when causing less than 50% stenosis, are associated with an increased risk of vascular events such as myocardial infarction (MI), stroke, and vascular death [3]. One supplemental method may be to screen for carotid artery calcifications (CACs) in panoramic radiographs (PRs) performed in patients for odontological reasons
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