Intracranial aneurysm is predicted by abdominal aortic calcification index: A retrospective case-control study. (October 2021)

• Record Type: Journal Article
• Authors: Rantasalo, Ville; Gunn, Jarmo; Kiviniemi, Tuomas; Hirvonen, Jussi; Saarenpää, Ilkka; Kivelev, Juri; Rahi, Melissa; Lassila, Elli; Rinne, Jaakko; Laukka, Dan
• Is Part Of: Atherosclerosis. Volume 334(2021)
• Page Start: 30
• Page End: 38
• Publication Date: 2021-10
• Subjects: Intracranial aneurysm -- Calcification -- Atherosclerosis -- Subarachnoid hemorrhage; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2021.08.027
• Languages: English
• ISSNs: 0021-9150

Abstract

Abstract: Background and aims: Patients with intracranial aneurysms (IA) have excess mortality for cardiovascular diseases, but little is known on whether atherosclerotic manifestations and IA coexist. We investigated abdominal aortic calcification index (ACI) association with unruptured and ruptured IAs. Methods: This retrospective case-control study reviews all tertiary centers patients (n = 24, 660) who had undergone head computed tomography angiography (CTA), magnetic resonance angiography (MRA) or digital subtraction angiography (DSA) for any reason between January 2003 and May 2018. Patients (n = 2020) with unruptured or ruptured IAs were identified, and patients with available abdominal CT were included. IA patients were matched by sex and age to controls (available abdomen CT, no IAs) in ratio of 1:3. ACI was measured from abdomen CT scans and patient records were reviewed. Results: 1720 patients (216 ruptured IA (rIA), 246 unruptured IA (UIA) and 1258 control) were included. Mean age was 62.9 ± 11.9 years and 58.2% were female. ACI (OR 1.02 per increment, 95%CI 1.01–1.03) and ACI>3 (OR 5.77, 95%CI 3.29–10.11) increased risk for rIA compared to matched controls. UIA patients' ACI was significantly higher but ACI did not increase odds for UIA compared to matched controls. History of coronary artery disease was less frequent in rIA patients. There was no calcification in aorta in 8.8% rIA and 13.6% UIA patients (matched controls 25.7% and 22.6% respectively, p < 0.01). Conclusions: Aortic calcification is greater in rIA and UIA patients than matched controls. ACI increases risk for rIAs. Graphical abstract: Image 1 Highlights: Abdominal aortic calcification index (ACI) was measured from abdomen CT in patients with ruptured or unruptured intracranial aneurysms (IA) and matched (age/sex) controls without IA. Higher ACI is associated with intracranial aneurysms, especially ruptured IA. Higher ACI increases risk for both ruptured and unruptured IA. ACI reflects systemic atherosclerotic burden. Atherosclerosis is defined by chronic systemic inflammation. Inflammation has a key role in the pathophysiology of IA. Association between systemic atherosclerosis and IA is yet poorly studied.