Abstract 3489: Presence of Thoracic Aorta Calcification Predicts All Cause Mortality Independent of Traditional Cardiovascular Risk Factors and Coronary Artery Calcification
Background: Recent guidelines have suggested that presence of coronary artery calcium (CAC) is an independent marker of adverse cardiovascular disease (CVD) events and mortality. However the predictive value of thoracic aorta calcification (TAC) that can be additionally identified without further scanning during assessment of CAC is unknown.
Method: We followed a cohort of 8418 asymptomatic individuals (mean age: 53 ± 10 years, 69% men) undergoing cardiac risk factor evaluation and coronary calcium testing with electron-beam CT for median period of 5.0 years. Multivariable Cox proportional hazards models were developed to predict all-cause mortality obtained from the National Death Index with presence of TAC.
Results: 141 (2%) all cause deaths were recorded. Overall survival was 96.7% and 98.8% for subjects with and without detectable TAC (p < 0.0001). As compared to those with absent TAC (reference group) the hazard ratio for mortality for subjects with TAC was 3.07 (95% CI: 2.20 – 4.38) in unadjusted analyses (table⇓). After taking into account age, gender and CVD risk factors the association was reduced to 1.77 (95% CI: 1.11–2.29). The association of TAC with mortality remained statistically significant even after taking into account CAC (table⇓), although TAC appeared to predict events more strongly in the absence of CAC (HR: 2.81; 95% CI: 1.17– 6.79, p = 0.02) than with CAC > 0 (HR: 1.39; 95% CI: 0.93–2.08, p = 0.10). However the interaction term between TAC and CAC for mortality was not significant (p = 0.23).
Conclusions: Presence of TAC was associated with all-cause mortality in our study. This relationship was independent of conventional CVD risk factors and CAC.