OBJECTIVE: This study was undertaken to determine whether there is a significant association between aortic arch calcification (AAC) on digital chest radiography (DCXR) and cerebrovascular disease (CVD) by computed tomography of the brain plain (BCT). It also aimed to determine if DCXR may be used to predict stroke.
RESEARCH DESIGN: Retrospective Cross Sectional Chart Review Design
METHODOLOGY: All the 483 patients who underwent DCXR and BCTs at the Doctors Hospital, Inc. from January 2010 to December 2012 were included in the study. Demographic data and risk factors for atherosclerosis and CVD were obtained and analyzed. The DCXR were graded by three radiologists and its association with CVD on BCT using the Chi Square Test of Independence was done. Krusskall Wallis Test was employed. Cochrane Inter rater validity between the three readers was tested. Odds ratio, sensitivity and specificity of DCXR to diagnose CVD on BCT were then determined.
RESULTS: Of the 483 patients included in the study, 52.8% were females with an average age of 65.86±14.46 years old. Patients of the older age group had a higher AAC grade (3) and had more infarcts on BCT. Although risk factors for AAC on DCXR and CVD on BCT were hypertension, dyslipidemia and renal disease, these were not statistically significant. Cross sectional analysis of variables showed that patients with an AAC grade of 1 was highly associated with infarcts and an AAC grade of 2 was associated with hemorrhagic stroke (p=0.0200). A statistically significant inter rater agreement was noted among the three radiologists that read the DCXR.
CONCLUSION: The AAC grade (1) on DCXR is significantly associated with infarcts on BCT scan with a high specificity and strong positive predictive value. Larger studies may be necessary to determine the association of the other AAC grades (2 and 3) with the types of stroke.