Abstract 16065: Impact of Aortic, Aortic Valve or Mitral Valve Annulus Calcification Found on Coronary Artery Calcium Scan on All-cause Mortality
Introduction: Calcification in the Aortic Valve (AV), Mitral Valvular Annulus (MVA) and Ascending Aorta (AA) share many histopathologic similarities to coronary atherosclerosis. It is uncertain if valvular or aortic calcification carry increased mortality risk independently of coronary atherosclerosis.
Methods: All patients who underwent coronary artery calcium (CAC) scan in our institution between 1998 and 2012 (n=17611) were included. Patients were tested for height, weight, blood pressure and lipid profile and were questioned about medical history and cardiovascular risk factors. At the end of 2012 mortality data were collected. We examined the associations between calcification in the AV, MVA or AA to mortality.
Results: Over a mean follow up of 8.9 years, crude mortality rates were 2.5 per 1000 patient-years (PY) for patients with no extra-coronary calcification compared with 12.3/1000PY, p<0.001. After adjusting for risk factors and CAC score, the association remained significant (Hazard Ratio (HR) 1.73 (95% CI 1.3-2.4), 1.45 (1.1-2) and 1.27 (1-1.6) for AV, MVA and AA calcification, respectively). for the patients with no CAC (n=8562), the presence of extra-coronary calcification was associated with increased mortality risk (5.6 deaths/1000PY compared with 1.7 deaths/1000PY; p<0.001). The adjusted mortality rates were significantly higher among patients with AV or MVA calcification (HR 2.25 (1.5-5.1) and 2.55 (1.1-6.7), respectively). These results were attenuated among patients with extensive coronary calcification (CAC score >399). In the intermediate group (CAC score 1-399) only AV calcification remained a significant independent predictor of mortality (HR 2.02 (1.38-2.97)).
Conclusions: In this large contemporary cohort of CAC screening population, calcification in the AV, MVA or ascending aorta was a predictor of all-cause mortality. This association was highly significant among the patients with no coronary artery calcium.
Author Disclosures: Y. Arnson: None. A. Rozanski: None. H. Gransar: None. S.W. Hayes: None. J.D. Friedman: None. L.E. Thomson: None. D.S. Berman: None.
- © 2016 by American Heart Association, Inc.