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Carotid artery atheromas and calcifications among postmenopausal women with histories of cerebrovascular or cardiovascular problems

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Abstract

Objectives

The aims of this study were to determine the prevalence of carotid stenosis and its relationship with carotid artery calcifications among postmenopausal women with recent histories of stroke or ischemic heart diseases (IHD), and to compare these findings with healthy controls.

Methods

Forty-five postmenopausal Iraqi women were recruited for the study. Of these, 15 were considered healthy according to their clinical and biochemical investigations, 15 had a recent history of stroke, and 15 had a history of myocardial infarction and/or angina pectoris. All participants underwent dental panoramic imaging (DPI) to investigate their carotid artery calcifications, and carotid region Doppler ultrasonography (DUS) for observation of narrowing and measurements of peak systolic velocity, peak end-diastolic velocity, and percent stenosis of the carotid arteries on both sides.

Results

All 90 carotid arteries were examined. The sensitivity and positive predictive value (PPV) were used to determine the diagnostic performances of DPI and DUS in detecting significant stenosis. The PPVs of carotid atheromal calcifications (CACs) detected by DPI and atheromatous plaque detected by DUS for predicting significant carotid artery stenosis were high among patients with a history of IHDs and patients with a history of stroke. The prevalence ratios of CACs were 2.7 and 2.3 times higher in these groups than in the control group, respectively.

Conclusions

Carotid artery calcifications may predispose postmenopausal women to cerebrovascular events. The presence of carotid artery calcifications on DPI of postmenopausal women necessitates the use of DUS as a cost-effective method to confirm the diagnosis.

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References

  1. Brown HA, Lawrence-Wright MB, Shah S, Lawrence SG, Gilbert D, Crandon I. Prevalence of carotid stenosis in a high-risk Caribbean population. Stroke. 2009;40(5):1892–3.

    Article  PubMed  Google Scholar 

  2. Friedlander AH, Lande A. Panoramic radiographic identification of carotid arterial plaques. Oral Surg Oral Med Oral Pathol. 1981;52(1):102–4.

    Article  PubMed  Google Scholar 

  3. Lewis DA, Brooks SL. Carotid artery calcification in a general dental population: a retrospective study of panoramic radiographs. Gen Dent. 1999;47(1):98–103.

    PubMed  Google Scholar 

  4. Almog DM, Horev T, Illig KA, Green RM, Carter LC. Correlating carotid artery stenosis detected by panoramic radiography with clinically relevant carotid artery stenosis determined by duplex ultrasound. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(6):768–73.

    Article  PubMed  Google Scholar 

  5. Jacobs NM, Grant EG, Schellinger D, Byrd MC, Richardson JD, Cohan SL. Duplex carotid sonography: criteria for stenosis, accuracy, and pitfalls. Radiology. 1985;154:385–91.

    PubMed  Google Scholar 

  6. Moneta GL, Edwards JM, Papanicolaou G, Hatsukami T, Taylor LM Jr, Strandness DE Jr, et al. Screening for asymptomatic internal carotid artery stenosis: duplex criteria for discriminating 60% to 99% stenosis. J Vasc Surg. 1995;21(6):989–94.

    Article  PubMed  Google Scholar 

  7. Huston J III, James EM, Brown RD Jr, Lefsrud RD, Ilstrup DM, Robertson EF, et al. Redefined duplex ultrasonographic criteria for diagnosis of carotid artery stenosis. Mayo Clin Proc. 2000;75(11):1133–40.

    Article  PubMed  Google Scholar 

  8. Filis KA, Arko FR, Johnson BL, Pipinos II, Harris JE, Olcott C, et al. Duplex ultrasound criteria for defining the severity of carotid stenosis. Ann Vasc Surg. 2002;16(4):413–21.

    Article  PubMed  Google Scholar 

  9. Staikov IN, Nedeltchev K, Arnold M, Remonda L, Schroth G, Sturzeneger M, et al. Duplex sonographic criteria for measuring carotid stenoses. J Clin Ultrasound. 2002;30(5):275–81.

    Article  PubMed  Google Scholar 

  10. Robinson ML, Sacks D, Perlmutter GS, Marinelli DL. Diagnostic criteria for duplex sonography. AJR Am J Roentgenol. 1988;151(5):1045–9.

    PubMed  Google Scholar 

  11. Hunink MGM, Polak JF, Barlan MM, O’Leary DH. Detection and quantification of carotid artery stenosis: efficacy of various Doppler velocity parameters. AJR Am J Roentgenol. 1993;160:619–25.

    PubMed  Google Scholar 

  12. Grant EG, Duerinckx AJ, El Saden SM, Melany ML, Hathout GM, Zimmerman PT, et al. Ability to use duplex US to quantify internal carotid arterial stenoses: fact or fiction? Radiology. 2000;214:247–52.

    PubMed  Google Scholar 

  13. Farman AG. Panoramic radiology and the detection of carotid atherosclerosis. Panor Imaging News. 2001;1(2):1–5.

    Google Scholar 

  14. Koga M, Kimura K, Minematsu K, Yamaguchi T. Diagnosis of internal carotid artery stenosis greater than 70% with power Doppler duplex sonography. AJNR Am J Neuroradiol. 2001;22:413–7.

    PubMed  Google Scholar 

  15. Riccio SA, House AA, Spence JD, Fenster A, Parraga G. Carotid ultrasound phenotypes in vulnerable populations. Cardiovasc Ultrasound. 2006;4:44.

    Article  PubMed  Google Scholar 

  16. Taveras JM, Ferrucci JT. Radiology diagnosis imaging intervention. 1st ed. Philadelphia: Lippincott, William & Wilkins; 2001.

  17. Kishikawa K, Kamouchi M, Okada Y, Inoue T, Ibayashi S, Lida M. Evaluation of distal extracranial internal carotid artery by transoral carotid ultrasonography of patients with severe carotid stenosis. AJNR Am J Neuroradiol. 2002;23(6):924–8.

    PubMed  Google Scholar 

  18. Friedlander AH, Maeder LA. The prevalence of calcified artery atheromas on the panoramic radiographs of patients with type 2 diabetes mellitus. J Am Dent Assoc. 2002;133(11):1516–23.

    PubMed  Google Scholar 

  19. Friedlander AH, Altman L. Carotid artery atheromas in postmenopausal women. Their prevalence on panoramic radiographs and their relationship to atherogenic risk factors. J Am Dent Assoc. 2001;132(8):1130–6.

    PubMed  Google Scholar 

  20. Applebaum-Bowden D, Mclean P, Steinmetz A. Lipoprotein, apolipoprotein, and lipolytic enzyme changes following estrogen administration in postmenopausal women. J Lipid Res. 1989;30:1895–906.

    PubMed  Google Scholar 

  21. Bayram B, Uckan S, Acikgoz A, Muderrisoglu H, Aydinalp A. Digital panoramic radiography: a reliable method to diagnose carotid artery atheromas? Dentomaxillofac Radiol. 2006;35(4):266–70.

    Article  PubMed  Google Scholar 

  22. Cohen SN, Friedlander AH, Jolly DA, Date L. Carotid calcification on panoramic radiographs: an important marker for vascular risk. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94:510–4.

    Article  PubMed  Google Scholar 

  23. Carter LC, Tsimidis K, Fabiano J. Carotid calcifications on panoramic radiography identify an asymptomatic male patient at risk for stroke. A case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85(1):119–22.

    Article  PubMed  Google Scholar 

  24. Glagov S, Weisenberg E, Zarins CK, Stankunavicim R, Kolettis GJ. Compensatory enlargement of human atherosclerotic carotid arteries. N Engl J Med. 1987;36:1371–5.

    Article  Google Scholar 

  25. Thunthy KH. Dental radiographic diagnosis. 2nd ed. Tulsa: PennWell Publishing; 2007.

  26. Sangiorgi G, Rumberger JA, Severson A, Edward WD, Gregoire J, Fitzpatrick LA, et al. Arterial calcification and not lumen stenosis is highly correlated with atherosclerotic plaque burden in humans: a histologic study of 723 coronary artery segments using nondecalcifying methodology. J Am Coll Cardiol. 1998;31(1):126–33.

    Article  PubMed  Google Scholar 

  27. Neschis DG, Lexa FG, Davis JT, Carpenter JP. Duplex criteria for determination of 50% or greater carotid stenosis. J Ultrasound Med. 2001;20(3):207–15.

    PubMed  Google Scholar 

  28. Sutton-Tyrrell K, Lassila HC, Meilahn E, Bunker C, Matthews KA, Kuller LH. Carotid atherosclerosis in premenopausal and postmenopausal women and its association with risk factors measured after menopause. Stroke. 1998;29:1116–21.

    Article  PubMed  Google Scholar 

  29. Carter LC, Haller AD, Nadarajah V, Calamel AD, Aguirre A. Use of panoramic radiography among an ambulatory dental population to detect patients at risk of stroke. J Am Dent Assoc. 1997;128(7):977–84.

    PubMed  Google Scholar 

  30. Uthman AT, Al-Saffar AB. Prevalence in digital panoramic radiographs of carotid area calcification among Iraqi individuals with stroke-related disease. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;105(4):e68–73.

    Article  Google Scholar 

  31. Fukuta Y, Kimura T, Totsuka M. Oral findings of patients with cardiovascular disease: remaining tooth number and panoramic radiographic findings. Jpn J Oral Diag Oral Med. 2003;16:15–21.

    Google Scholar 

  32. Friedlander AH, Manesh F, Wasterlain CG. Prevalence of detectable carotid artery calcifications on panoramic radiographs of recent stroke victims. Oral Surg Oral Med Oral Pathol. 1994;77(6):669–73.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Oral Diagnosis Department, College of Dentistry, University of Baghdad, Baghdad, Iraq

    Asmaa T. Uthman & Lamia H. Al-Nakib

  2. Wasity Hospital, Ministry of Health, Baghdad, Iraq

    Baydaa H. Al-Saleem

  3. Community Medicine Department, College of Medicine, University of Baghdad, Baghdad, Iraq

    Ahmed S. Al-Naimi

Authors
  1. Asmaa T. Uthman
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  2. Lamia H. Al-Nakib
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  3. Baydaa H. Al-Saleem
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  4. Ahmed S. Al-Naimi
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Correspondence to Asmaa T. Uthman.

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Uthman, A.T., Al-Nakib, L.H., Al-Saleem, B.H. et al. Carotid artery atheromas and calcifications among postmenopausal women with histories of cerebrovascular or cardiovascular problems. Oral Radiol 28, 1–9 (2012). https://doi.org/10.1007/s11282-011-0073-x

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  • DOI: https://doi.org/10.1007/s11282-011-0073-x

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