Calcified Carotid Plaques Show Double Symptomatic Peaks According to Agatston Calcium Score

Comparison of Carotid Plaque Score and Coronary Artery Calcium Score for Predicting Cardiovascular Disease Events: The Multi‐Ethnic Study of Atherosclerosis

“…[26][27][28] It has been proposed that the heterogeneity of mechanisms of cerebrovascular events is a plausible explanation for why more-recent findings contradict the previously emphasized importance of the anatomical location of subclinical disease in regard to the type of events they predict. 11,16,29,30 This study highlights that although CAC score was, overall, a better predictor of CVD and CHD events, the carotid plaque score had similar predictive value for stroke/TIA events-as predicted by their anatomical location. Though inferior to CAC score for predicting CVD and CHD events, carotid ultrasound remains a relatively inexpensive, noninvasive, radiation-free technique to augment CVD risk prediction, so it may be a more-suitable test in children and young adults.…”

“…Similarly, the carotid plaque score is associated with future CHD events despite distance between the carotid and coronary arterial beds . It has been proposed that the heterogeneity of mechanisms of cerebrovascular events is a plausible explanation for why more‐recent findings contradict the previously emphasized importance of the anatomical location of subclinical disease in regard to the type of events they predict …”

Calcification in Atherosclerotic Plaque Vulnerability: Friend or Foe?

“…The symptomatic rate increases along with the calcium score until 500. Afterward, the symptomatic rate decreases with the calcium score archiving its highest level (>800) (Katano et al, 2015). This finding might be generally consistent with the hypothesis, but it does not give a good explanation of the core problem -the surface area.…”

“…Nevertheless, this hypothesis is difficult to prove since the interface area of calcification is hard to observe and measure. Katano et al (2015) divided calcification formation into two sections at a calcium score of 500. The symptomatic rate increases along with the calcium score until 500.…”

“…Several studies have tried to investigate calcification morphology including quantification of calcium shape score (Katano et al, 2015(Katano et al, , 2017. Referring to the degree of each calcification encircling the vessel with CTA, the shape of the calcification was stratified and scored from 1 to 5: 1, less than one-quarter; 2, one-quarter to one-half; 3, one-half to three-quarters; 4, three-quarters to full circle; and 5, full circle covering the entire carotid perimeter (Katano et al, 2015). Low symptomatic calcified carotid plaques (<40%) tend to have calcification with significantly high calcium scores and high calcium shape scores (circularities) (Katano et al, 2015).…”