{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T02:18:06Z","timestamp":1789870686115,"version":"4.0.1"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Although coronary calcification quantification is an established approach for cardiovascular risk assessment, the value of quantifying carotid calcification is less clear. As a result, we performed a systematic review and meta-analysis to evaluate the association between extracranial carotid artery plaque calcification burden and ipsilateral cerebrovascular ischemic events.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>A comprehensive literature search was performed in the following databases: Ovid MEDLINE(R) 1946 to July 6, 2022; OVID Embase 1974 to July 6, 2022; and The Cochrane Library (Wiley). We performed meta-analyses including studies in which investigators performed a computed tomography assessment of calcification volume, percentage, or other total calcium burden summarizable in a single continuous imaging biomarker and determined the association of these features with the occurrence of ipsilateral stroke or transient ischemic attack.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Our overall meta-analysis consisted of 2239 carotid arteries and 9 studies. The presence of calcification in carotid arteries ipsilateral to ischemic stroke or in stroke patients compared with asymptomatic patients did not demonstrate a significant association with ischemic cerebrovascular events (relative risk of 0.75 [95% CI, 0.44\u20131.28];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.29). When restricted to studies of significant carotid artery stenosis (&gt;50%), the presence of calcification was associated with a reduced risk of ischemic stroke (relative risk of 0.56 [95% CI, 0.38\u20130.85];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.006). When the analysis was limited to studies of patients with mainly nonstenotic plaques, there was an increased relative risk of ipsilateral ischemic stroke of 1.72 ([95% CI, 1.01\u20132.91];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.04). Subgroup meta-analyses of total calcium burden and morphological features of calcium showed wide variability in their strength of association with ischemic stroke and demonstrated significant heterogeneity.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>The presence of calcification in carotid plaque confers a reduced association with ipsilateral ischemic events, although these results seem to be limited among carotid arteries with higher degrees of stenosis. Adoption of carotid calcification measures in clinical decision-making will require additional studies providing more reproducible and standardized methods of calcium characterization and testing these imaging strategies in prospective studies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.123.042807","type":"journal-article","created":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T09:00:19Z","timestamp":1693213219000},"page":"2621-2628","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":31,"title":["Extracranial Carotid Plaque Calcification and Cerebrovascular Ischemia: A Systematic Review and Meta-Analysis"],"prefix":"10.1161","volume":"54","author":[{"given":"Moayad","family":"Homssi","sequence":"first","affiliation":[{"name":"Department of Radiology, Weill Cornell Medicine, New York, NY (M.H., M.L., A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8446-6315","authenticated-orcid":true,"given":"Atin","family":"Saha","sequence":"additional","affiliation":[{"name":"Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY (A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6290-3497","authenticated-orcid":true,"given":"Diana","family":"Delgado","sequence":"additional","affiliation":[{"name":"Samuel J. Wood Library and C.V. Starr Biomedical Information Center, Weill Cornell Medicine, New York, NY (D.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arindam","family":"RoyChoudhury","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Weill Cornell Medicine, New York, NY (A.R.C., C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlene","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Weill Cornell Medicine, New York, NY (A.R.C., C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Radiology, Weill Cornell Medicine, New York, NY (M.H., M.L., A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6251-5769","authenticated-orcid":true,"given":"Hediyeh","family":"Baradaran","sequence":"additional","affiliation":[{"name":"Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City (H.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5745-0307","authenticated-orcid":true,"given":"Hooman","family":"Kamel","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY (H.K.)."},{"name":"Feil Family Brain Mind Institute, Weill Cornell Medicine, New York, NY (H.K., A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2816-0340","authenticated-orcid":true,"given":"Ajay","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Radiology, Weill Cornell Medicine, New York, NY (M.H., M.L., A.G.)."},{"name":"Feil Family Brain Mind Institute, Weill Cornell Medicine, New York, NY (H.K., A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.30.9.1751"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A5436"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.002551"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.006091"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oooo.2015.10.011"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.023273"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.659156"},{"key":"e_1_3_3_9_2","first-page":"750","article-title":"The correlation between calcification in carotid plaque and stroke: calcification may be a risk factor for stroke.","volume":"12","author":"Kan Y","year":"2019","unstructured":"Kan, Y, He, W, Ning, B, Li, H, Wei, S, Yu, T. The correlation between calcification in carotid plaque and stroke: calcification may be a risk factor for stroke. 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Iran J Public Health. 2019;48:1052\u20131058.","journal-title":"Iran J Public Health"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A6160"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A6189"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2009.03.009"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2078"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2015.02.010"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2010.06.037"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000191391.71614.51"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12968-014-0084-y"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2020.00056"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.121.035692"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.123.042807","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T19:28:41Z","timestamp":1748978921000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.123.042807"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10]]},"references-count":34,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1161\/STROKEAHA.123.042807"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.123.042807","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10]]},"assertion":[{"value":"2023-03-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-06","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}