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(Stroke. 2002;33:462.)
© 2002 American Heart Association, Inc.

Original Contributions

Stroke Is Associated With Coronary Calcification as Detected by Electron-Beam CT

The Rotterdam Coronary Calcification Study

Rozemarijn Vliegenthart, MSc; Monika Hollander, MD; Monique M.B. Breteler, MD, PhD; Deirdre A.M. van der Kuip, MD, PhD; Albert Hofman, MD, PhD; Matthijs Oudkerk, MD, PhD Jacqueline C.M. Witteman, PhD

Department of Epidemiology & Biostatistics (R.V., M.H., M.M.B.B., D.A.M. van der K., A.H., J.C.M.W.) and Department of Radiology, Daniel den Hoed Clinic (M.O.), Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands, and Department of Radiology, State University Groningen/Academic Hospital Groningen, Groningen, The Netherlands (M.O., R.V.).

Reprint requests to J.C.M. Witteman, PhD, Department of Epidemiology & Biostatistics, Erasmus Medical Center Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands. E-mail witteman{at}epib.fgg.eur.nl

Background and Purpose— Coronary calcification as detected by electron-beam CT measures the atherosclerotic plaque burden and has been reported to predict coronary events. Because atherosclerosis is a generalized process, coronary calcification may also be associated with manifest atherosclerotic disease at other sites of the vascular tree. We examined whether coronary calcification as detected by electron-beam CT is related to the presence of stroke.

Methods— From 1997 onward, subjects were invited to participate in the prospective Rotterdam Coronary Calcification Study and undergo electron-beam CT to detect coronary calcification. The study was embedded in the population-based Rotterdam Study. Calcifications were quantified in a calcium score according to Agatston’s method. Calcium scores were available for 2013 subjects (mean age [SD], 71 [5.7] years). Fifty subjects had experienced stroke before scanning.

Results— Subjects were 2 times more likely to have experienced stroke when their calcium score was between 101 and 500 (odds ratio [OR], 2.1; 95% CI, 0.9 to 4.7) and 3 times more likely when their calcium score was above 500 (OR, 3.3; 95% CI, 1.5 to 7.2), compared with subjects in the lowest calcium score category (0 to 100). Additional adjustment for cardiovascular risk factors did not materially alter the risk estimates.

Conclusions— In this population-based study, a markedly graded association was found between coronary calcification and stroke. The results suggest that coronary calcification as detected by electron-beam CT may be useful to identify subjects at high risk of stroke.

Key Words: atherosclerosis • calcium • epidemiology • stroke • tomography

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