{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T10:47:06Z","timestamp":1794048426784,"version":"4.8.0"},"reference-count":29,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Intracranial arterial calcification (ICAC) is common, but data on its impact on future stroke risk and outcomes remain limited. We conducted a systematic review and meta-analysis to investigate the association of ICAC with stroke risk and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We searched three multidisciplinary databases from inception to July 2025. We selected studies that investigated incidence of stroke and its outcomes in patients with ICAC. We assessed the studies\u2019 risk of bias using the Newcastle Ottawa Quality Assessment Scale. Statistical analysis was conducted using Cochrane Review Manager (RevMan 5.4).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>After reviewing 660 citations, we selected 94 studies for full-text screening. We extracted data from a total of 20 studies, reporting outcomes on 14,599 patients. Overall, the risk of bias was low. The included studies were heterogeneous, with varying outcomes assessed and differing measures of associations reported. ICAC was associated with an increased risk of ischaemic stroke, with a pooled odds ratio (OR) of 2.28 (95% confidence interval (CI): 1.39\u20133.73), and one study reported a hazard ratio (HR) of 1.49 (95% CI: 1.24\u20131.78). ICAC also showed a trend toward increased mortality, with a pooled OR 1.40 (95% CI: 0.96\u20132.05) and high heterogenicity across the studies (I\u00b2\u2009=\u200965%). The pooled HR per 1-standard deviation (1-SD) increase in ICAC was 1.25 (95% CI: 1.10\u20131.42), with low heterogenicity (I\u00b2\u2009=\u20091%) between 2 studies reporting the HR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>ICAC is significantly associated with an increased risk of stroke as well as a trend toward increased mortality (PROSPERO ID: CRD42023414813).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17474930251372693","type":"journal-article","created":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T04:30:42Z","timestamp":1755923442000},"page":"335-342","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Intracranial arterial calcification as a marker of stroke risk and worse stroke outcomes in adults: A systematic review and meta-analysis"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4992-0620","authenticated-orcid":false,"given":"Sandra","family":"Elsheikh","sequence":"first","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital, Liverpool, UK"},{"name":"Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK"},{"name":"Mersey and West Lancashire Teaching Hospitals NHS Trust, Prescot, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"McKeever","sequence":"additional","affiliation":[{"name":"The Walton Centre NHS Foundation Trust, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg J","family":"Irving","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital, Liverpool, UK"},{"name":"Health Research Institute, Edge Hill University, Ormskirk, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M","family":"Hill","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital, Liverpool, UK"},{"name":"Mersey and West Lancashire Teaching Hospitals NHS Trust, Prescot, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory YH","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital, Liverpool, UK"},{"name":"Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK"},{"name":"Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1318-4027","authenticated-orcid":false,"given":"Azmil H","family":"Abdul-Rahim","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital, Liverpool, UK"},{"name":"Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK"},{"name":"Mersey and West Lancashire Teaching Hospitals NHS Trust, Prescot, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2013.6223"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.308441"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.017821"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.559158"},{"key":"e_1_3_3_6_2","first-page":"20149","article-title":"Coronary artery calcium score\u2014a reliable indicator of coronary artery disease?","volume":"13","author":"Shreya D","year":"2021","unstructured":"Shreya D, Zamora DI, Patel GS, et al. 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