Abstract 2755: Determinants of Differential Patterns of Coronary Calcification - Results from the German Myocardial Infarction Family Study
Introduction: In patients with CAD coronary calcification (CC) is found to a highly variable extent. Both, the severity of CC as well as the anatomical localization (intima vs. media; left vs. right coronary) differ considerably. This study intends to further investigate the cardiovascular risk profiles of CAD patients according to the degree and distribution of CC evaluated by coronary angiography.
Methods: Analyses were performed in a sample from the German Myocardial Infarction Family Study. Patterns of cardiovascular risk profiles were studied 1. in participants with CAD but no CC (n=316), 2. with low-grade diffus CC (n=313), 3. with severe-grade diffus CC (n=156), and 4. predominant circular (Mönkeberg-like) CC (n=54).
Results: In comparison with CAD patients without visible calcification (57.7 years), age was higher in the 2nd , 3rd, and 4th group (60.2 [p<0.001], 62.5 [p<0.001], and 60.3 years [p=0.015]). Likewise, systolic blood pressure was lower in group 1 (134.0 mmHg) as compared to groups 2– 4 (137.4 [p=0.023], 142.0 [p=0.001], and 142.1 mmHg [p=0.004]). Moreover, pulse pressure was significantly elevated with increasing degree of CC (52.3 mmHg for group
55.7 mmHg, p=0.004; vs.
59.2 mmHg, p<0.001; vs.
58.8 mmHg, p=0.002).
The prevalence of diabetes was significantly elevated in group 3 with severe-grade diffus CC (21.3% vs. (1) 13.5%, p=0.025), whereas the lowest prevalence of myocardial infarction was found in this group (67.7% vs. (1) 80.5%, p=0.005). Finally, we identified a positive history for CC as a predictor for CC (p<0.001). No differences for body mass index, LDL cholesterol, and smoking habbits were found according to different degrees of calcification. In a multivariate analysis, CC was independently related to age, systolic blood pressure and positive history for CC.
Conclusions: The angiographic phenotype of CC is associated with older age, increasing pulse pressure, diabetes, and a positive family history for CC, whereas history of myocardial infarction is less frequent among patients with severe-grade calcification as compared to CAD patients without CC. Further follow up of this sample will focus on prognostic implications araising from differential patterns of CC.