Advanced Coronary Artery Calcification and Cerebral Small Vessel Diseases in the Healthy Elderly

• Published in: Circulation Journal Vol. 75; no. 2; pp. 451 - 456
• Main Authors: Kim, Beom Joon, Lee, Seung-Hoon, Kim, Chi Kyung, Ryu, Wi-Sun, Kwon, Hyung-Min, Choi, Su-Yeon, Yoon, Byung-Woo
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 2011
• Subjects: Aged; Aged, 80 and over; Aging - pathology; Atherosclerosis - epidemiology; Calcinosis - diagnostic imaging; Calcinosis - epidemiology; Calcinosis - etiology; Calcinosis - physiopathology; Cell Transdifferentiation; Cerebral microbleeds; Cerebral small vessel disease; Cerebrovascular Disorders - epidemiology; Cognition Disorders - etiology; Comorbidity; Coronary artery calcification; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - epidemiology; Coronary Artery Disease - etiology; Coronary Artery Disease - physiopathology; Humans; Hyperphosphatemia - complications; Middle Aged; Models, Cardiovascular; Muscle, Smooth, Vascular - metabolism; Muscle, Smooth, Vascular - pathology; Risk Factors; Silent lacunar infarction; Tomography, Spiral Computed; Tomography, X-Ray Computed; Tunica Intima - pathology; Tunica Media - pathology; Vascular Resistance; White matter lesion
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-10-0762

Background: Coronary artery calcification (CAC) scores are widely accepted to predict risk of coronary heart diseases and are associated with atherosclerosis in other vasculatures. Cerebral small vessel diseases (SVDs), including white matter lesions (WML), silent lacunar infarction (SLI) and cerebral microbleeds (CMB), are considered to develop in conjunction with pro-atherogenic conditions, measured by CAC scores. Methods and Results: Of 672 individuals aged ≥65 years that underwent health screening, 312 subjects with brain magnetic resonance imagings (MRIs) were enrolled in this study. The distribution of baseline characteristics among individuals with or without MRIs was not different. Clinical and laboratory information was collected and CAC scores were measured using multi-detector computed tomography. Cerebral SVD were independently assessed by 2 raters who were unaware of the CAC scores. The prevalence of CAC (CAC>0) was 71.7% in men and 50.0% in women. The associations between moderate-to-extensive CAC (CAC score ≥100) and WML (adjusted odds ratio and 95% confidence interval, 4.99 and 1.33-18.73), SLI (5.04 and 1.86-13.63) and CMB (6.07 and 1.54-23.94) remained significant after adjusting for relevant confounders. Conclusions: This study documents significant associations between CAC and cerebral SVDs. The findings suggest that SVDs in the brain and CAC in the heart may develop under similar systemic pathogenic processes. (Circ J 2011; 75: 451-456)