The utility of assessment of cardiovascular calcifications for predicting stroke incidence remains unclear. This study assessed the relationship between cardiovascular calcifications including coronary artery calcification (CAC), aortic valve (AVC), and aortic root (ARC) assessed by coronary computed tomography (CT) and stroke incidence in patients with suspected CAD. In this multicenter prospective cohort study, 1187 patients suspected of CAD who underwent coronary CT were enrolled. Cardiovascular events including stroke were documented. Hazard ratio (HR) and confidence interval (CI) were assessed by Cox proportional hazard model adjusted for the Framingham risk score. C statistics for stroke incidence were also examined by models including cardiovascular calcifications. A total of 980 patients (mean age, 65 ± 7 years; females, 45.8%) were assessed by the CAC, AVC, and ARC Agatston scores. During a median follow-up of 4.0 years, 19 patients developed stroke. Cox proportional hazard model showed severe CAC (Agatston score ≥ 90th percentile [580.0 value]) and presence of AVC and ARC were associated with stroke incidence (HR; 10.33 [95% CI; 2.08–51.26], 3.08 [1.19–7.98], and 2.75 [1.03–7.30], respectively). C statistic in the model with CAC and AVC severity for predicting stroke incidence was 0.841 (95% CI; 0.761–0.920), which was superior to the model with CAC alone (0.762 [95% CI; 0.665–0.859], P < 0.01). CAC, AVC, and ARC were associated with stroke incidence in patients suspected of CAD. Assessment of both CAC and AVC may be useful for prediction of stroke incidence.

心血管钙化评估对于预测中风发病率的效用尚不清楚。本研究评估了通过冠状动脉计算机断层扫描 (CT) 评估的心血管钙化（包括冠状动脉钙化 (CAC)、主动脉瓣 (AVC) 和主动脉根部 (ARC)）与疑似 CAD 患者中风发生率之间的关系。在这项多中心前瞻性队列研究中，纳入了 1187 名疑似 CAD 并接受冠状动脉 CT 治疗的患者。记录了包括中风在内的心血管事件。通过根据 Framingham 风险评分调整的 Cox 比例风险模型评估风险比 (HR) 和置信区间 (CI)。中风发生率的 C 统计数据也通过包括心血管钙化在内的模型进行了检查。共有 980 名患者（平均年龄，65 ± 7 岁；女性，45.8%）接受了 CAC、AVC 和 ARC Agatston 评分评估。在中位随访 4.0 年期间，19 名患者出现中风。 Cox 比例风险模型显示严重的 CAC（Agatston 评分≥ 90% [580.0 值]）以及 AVC 和 ARC 的存在与卒中发生率相关（HR；10.33 [95% CI；2.08–51.26]、3.08 [1.19–7.98]、和 2.75 [1.03–7.30]，分别）。 CAC 和 AVC 严重程度模型预测卒中发生率的 C 统计值为 0.841 (95% CI; 0.761–0.920)，优于单独 CAC 模型 (0.762 [95% CI; 0.665–0.859]，P  < 0.01 ）。 CAC、AVC 和 ARC 与疑似 CAD 患者的卒中发生率相关。 CAC 和 AVC 的评估可能有助于预测中风发生率。