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High Prevalence of Intracranial Artery Calcification in Stroke Patients with CKD: A Retrospective Study

Jean-Marc Bugnicourt^*, Jean-Marc Chillon^,, Ziad A Massy^,,, Sandrine Canaple^*, Chantal Lamy^*, Hervé Deramond^||, and Olivier Godefroy^*

^* Service de Neurologie, Centre Hospitalier Universitaire (CHU) Amiens, Amiens, France, and Laboratoire de Neurosciences Fonctionnelles et Pathologies (Centre National de la Recherche Scientifique, Unité Mixte de Recherche 8160), CHU Amiens, France; Université de Picardie Jules Verne, Amiens, France; Institut National de la Santé et de la Recherche Médicale, ERI12, Amiens, France; Services de Pharmacologie Clinique et Néphrologie, CHU Amiens, France; and ^|| Service de Radiologie A, CHU Amiens, France

Correspondence: Dr Jean-Marc Bugnicourt, Service de Neurologie, CHU Amiens, Place Victor Pauchet, F-80054 Amiens Cedex 1, France. Phone: + 33-3-322-366-382-3-340; Fax: +33-33-322-366-382-344; E-mail: bugnicourt.jean-marc{at}chu-amiens.fr

Background and objectives: Intracranial artery calcification (IAC) is frequently observed on brain computed tomography (CT) scans in stroke patients. This retrospective study was designed to determine the prevalence, risk factors, and clinical relevance of IAC in a cohort of patients with ischemic stroke.

Design, setting, participants, & measurements: We included all eligible patients admitted to Amiens University Hospital for acute ischemic stroke between January and December 2006 and assessed using 64-slice multidetector-row CT (n = 340). Patients were classified according to the presence or absence of IAC in the internal carotid arteries, middle cerebral arteries, vertebral arteries, and basilar artery. GFR was estimated using the MDRD equation. Chronic kidney disease (CKD) was defined as a GFR < 60 ml/min/1.73 m². We also studied a control group of patients admitted for neurologic diseases other than stroke.

Results: Two hundred fifty-nine stroke patients (76.2%) displayed IAC, which was independently associated with carotid atherosclerosis > 50%, age, and GFR. One hundred three nonstroke patients (60.2%) had IAC, with age, arterial hypertension, and GFR as independently associated factors. For all patients taken together, age, arterial hypertension, stroke, and GFR were independently associated with IAC.

Conclusion: These results confirm the high prevalence of IAC in patients with and without ischemic stroke and show for the first time that IAC is associated with the presence of CKD in these patients. The frequency of IAC was significantly higher in stroke patients than in nonstroke patients. The association between IAC and stroke outcome requires further investigation.