Abstract TP153: Intracranial Arterial Calcium Volume as a Prognostic Marker after Acute Ischemic Stroke

Edgar Ramírez-Vázquez1, Fernando Tienda-López2, Diego Alejandro Ortega-Moreno2, Emanuel Navarrete-Juárez2, David Loaiza-Pérez2, Horacio Chapa-Martínez2, Xavier González-Ballesteros3, Luis Huerta-Díaz2, Homero Nañez-Terrero1, Fernando Góngora-Rivera1,2. 1 Internal Medicine department, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México. 2Neurology department, Hospital Universitario “Dr. José Eleuterio González”, Universidad Aut& #x00F3;noma de Nuevo León, Monterrey, Nuevo León, México. 3 Radiology department, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México. Introduction: Intracranial arterial calcifications (IAC) are frequently observed as incidental findings on non-enhanced computerized tomography (CT) in patients with acute ischemic stroke (AIS). Although IAC reflects the underlying atherosclerotic burden, its prognostic significance remains uncertain. This study aimed to evaluate the association between IAC volume and short- and intermediate-term outcomes in AIS. Methods: We conducted a retrospective study of consecutive patients with AIS admitted between January 2017 and March 2018, using data from a prospectively maintained stroke registry. IAC volume was quantified through semi-automated segmentation of CT scans. Patients were stratified by IAC severity, with severe IAC defined as volumes in the highest quartile (≥245.8 mm3). Functional outcome was assessed using the modified Rankin Scale (mRS) at discharge and 90-day follow-up. Multivariable logistic regression models were constructed to evaluate associations with poor outcome (mRS >2) and mortality. Results: A total of 182 patients were included. IAC was identified in 85.2%, with a median volume of 105.3 mm3. Severe IAC was significantly associated with poor functional outcome at discharge (aOR 3.5, 95% CI 1.3–9.7, p = 0.014), but not at 90 days. Additionally, severe IAC showed increased odds of 90-day mortality when adjusted for age and sex (aOR 1.9, 95% CI 1.1–3.3, p = 0.02), although this association was not sustained in fully adjusted models. Conclusion: Higher IAC volumes were independently associated with worse short-term outcomes in AIS. These findings support the potential utility of IAC as a readily accessible imaging biomarker for early prognostic stratification.