Associations between coronary artery calcium score and cerebral artery disease: A retrospective cross-sectional observational study

Calcification plays a major role in atherosclerosis, a common pathological finding in coronary and cerebral artery diseases. Coronary artery calcium score (CACS) is a risk prediction marker for coronary artery disease. In the present study, we aimed to analyze the correlation between the CACS and large artery atherosclerosis of the cerebral artery and cerebral small vessel disease with different pathophysiologies. This study was designed as a retrospective cross-sectional observational study. Medical records of patients who underwent carotid artery duplex ultrasonography, brain magnetic resonance angiography, computed tomography angiography, and coronary computed tomography angiography during medical checkups at St. Vincent Hospital between January 2015 and February 2021 were retrospectively analyzed. In total, 521 patients were registered during the study period. Conventional risk factors, such as hypertension and diabetes mellitus, as well as CACS (119.34 ± 316.02 vs 13.12 ± 67.89), were significantly higher in patients with carotid plaques than in those without carotid plaques. Furthermore, the relationship between age (odds ratio [OR], 1.089), smoking (OR, 1.628), and CACS (OR, 1.009) in multivariate analysis of brain white matter hyperintensity was significant. Forty-seven patients had intracranial atherosclerosis and significant relationships were observed among age, hypertension, diabetes mellitus, and smoking status. CACS strongly correlated with cerebral larger artery disease and white matter hyperintensity, a small vessel disease, despite their different pathomechanisms. Evaluation of cerebral large vessel markers, including carotid intima-media thickness and small vessel disease, in patients with elevated CACS, can help detect early or subclinical cerebral artery disease.