Supplementary Material for: Aortic stiffness is independently associated with intracranial carotid artery calcification in patients with ischemic stroke

Background and aims Intracranial carotid artery calcification (ICAC), as a strong contributor to the occurrence of ischemic stroke, might be present in the medial or intimal arterial layer. Traditional cardiovascular risk factors (CVRFs) are associated with ICAC; however, its association with new markers of vascular function are less understood. The paper aims to evaluate the relationship between carotid-femoral pulse wave velocity (CF-PWV) and ICAC subtypes. Methods We enrolled 65 patients with ischemic stroke. CF-PWV, systolic, diastolic, mean blood pressure, and pulse pressure (SBP, DBP, MBP, PP) were measured within 6±2 days after stroke onset, CT was performed within 24 hours. ICAC on the stroke site was classified by two methods: volume- and score-based. Tertiles of ICAC volume were determined, and low-grade ICAC (T1) was regarded as a reference. According to the score-based method, (dominant) medial and (dominant) intimal ICAC subtypes were determined. Data were analysed with multivariate logistic regression. Results Medial and intimal ICAC subtypes were found in 34 (52%) and 24 (37%) patients, respectively. In 11% of patients no ICAC calcifications were found. CF-PWV was higher in patients with high-grade ICAC (OR=1.56, 95%CI=1.03-2.35, p=0.035). CF-PWV was higher in patients with the medial ICAC subtype (OR=1.60, 95%CI=1.00-2.55, p=0.049) after adjustment for traditional CVRFs. Conclusions Our study demonstrates that among patients with ischemic stroke, aortic stiffness is independently associated with ICAC, and that medial ICAC, compared with intimal ICAC, is accompanied by more advanced aortic stiffness.