Association between Warfarin Exposure and Intracranial Arterial Calcification in 645 Patients without Trauma

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Abstract
Prolonged warfarin use is associated with vascular calcification in several organs; however, its relationship with intracranial arterial calcification (IAC) remains unclear. This study investigated the association between warfarin exposure and IAC while identifying other predictive factors. Nontraumatic adult patients underwent non-contrast cranial computed tomography to evaluate IAC, which was classified as absent, mild, moderate, or severe across all intracranial arterial locations. Participants were divided into warfarin users and non-users, and data on age, duration of warfarin use, underlying diseases, and smoking were collected. Of 645 patients enrolled, 113 (17.5%) were warfarin users and 532 (82.5%) were non-users, with a median age of 73 years and median warfarin use duration of 4.5 years. Severe intracranial internal carotid artery calcification was statistically significantly more common in warfarin users (p = 0.012); however, multivariable analysis revealed no association between warfarin use and IAC at any location. Independent factors associated with severe IAC were older age, diabetes mellitus, coronary artery disease, ischemic cerebrovascular disease, and chronic kidney disease. Older age, hypertension, and ischemic cerebrovascular disease were associated with mild to moderate IAC. This study found no evidence supporting an association between warfarin exposure and IAC.

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