Abstract 10169: Calcium Deposits in Heart Valves and Aortic Root, Cardiovascular Risk Factors, Subclinical Coronary Atherosclerosis, and the Risk of Future Cardiovascular Events
Background: Aortic valve and root calcification (AVC, ARC) and mitral annular calcification (MAC) are sought to be a sign of aortosclerosis. However, limited information is currently available on an association between calcified atherosclerosis in the coronary artery, heart valves, and aortic root. The purpose of this study was to evaluate the association of calcium deposits in heart valves and aortic root with the traditional cardiovascular disease (CVD) risk factors, coronary artery calcification (CAC), and the risk of CVD mortality and morbidity.
Methods: A total of 943 patients with suspected coronary heart disease underwent echocardiography and computed tomography scans that were interrogated for AVC, ARC, MAC, and CAC. The presence of AVC, ARC, and MAC were diagnosed by echocardiography, and a total heart calcium (THC) score was determined by summing up the AVC, ARC, and MAC variables. The subjects were followed for a mean of 2.9 years to assess the risk of CVD events. CVD events were defined as CVD death or new episodes of acute coronary syndrome, congestive heart failure, stroke, or vascular diseases.
Results: AVC, ARC, and MAC were detected in 46.8%, 36.5%, and 15.4% of the total patient group. Independent CVD risk factors associated with AVC and ARC included age (both p < 0.001), hypertension (p = 0.003; p = 0.014), diabetes mellitus (p = 0.028; p < 0.001), hyperlipidemia (p = 0.003; p < 0.001), and current smoking (p = 0.091; p < 0.001); whereas MAC included age (p < 0.001), female gender (p = 0.01), body mass index (p = 0.037), and diabetes mellitus (p = 0.032). After adjustments for age, gender, and CVD risk factors, AVC, ARC, and MAC were independently correlated with CAC score (all p < 0.001). During follow-up there were 43 CVD deaths (4.6%) with a total of 160 CVD events (17.0%). After adjustments for age, gender, and CVD risk factors, Cox regression hazard ratios for CVD events, using no calcification as reference, were 2.13 (1.26-3.59, p = 0.005), 2.54 (1.50-4.29, p = 0.001) and 4.02 (2.23-7.24, p < 0.001) in the respectively increasing THC score values.
Conclusion: A significant association exists among calcium deposits in heart valves and aortic root, CVD risk factors, the amount of CAC, and the increased risk of future CVD events in a high-risk patient population.
- © 2013 by American Heart Association, Inc.