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Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
Published on: May 31, 2016
Relation of nonobstructive aortic valve calcium to carotid arterial atherosclerosis
1Department of Cardiology, Rabin Medical Center, Petah Tiqva, Israel.
Insights
Aortic valve calcium (AVC) is linked to a higher risk of stroke, potentially due to associated carotid artery atherosclerosis. This study found a significant association between AVC and carotid atherosclerotic disease, independent of traditional risk factors.
Area of Science:
- Cardiovascular Medicine
- Radiology
- Vascular Biology
Background:
- Aortic valve calcium (AVC) presence is associated with increased cardiovascular disease risk, including stroke.
- The underlying mechanism linking AVC to stroke risk remains incompletely understood.
- Carotid artery atherosclerosis is a known cause of stroke.
Purpose of the Study:
- To investigate the association between aortic valve calcium (AVC) and carotid artery atherosclerotic disease.
- To determine if AVC is an independent predictor of severe carotid stenosis.
Main Methods:
- Retrospective analysis of 3,949 patients diagnosed with AVC without significant stenosis.
- Carotid artery duplex ultrasound was performed on 279 AVC patients and 277 matched controls.
- Multivariate analysis was used to assess predictors of severe carotid atherosclerotic disease.
Main Results:
- The AVC group showed a significantly higher prevalence of carotid stenosis across all severity levels compared to controls.
- Severe carotid stenosis (>80% to 100%) was significantly more common in the AVC group (32% vs 14%).
- AVC was identified as the sole independent predictor of severe carotid atherosclerotic disease (stenosis >80% to 100%).
Conclusions:
- Aortic valve calcium is significantly associated with the presence and severity of carotid artery atherosclerotic disease.
- This association suggests that AVC may contribute to stroke risk through shared atherosclerotic pathways in the carotid arteries.
- AVC is an independent predictor of severe carotid stenosis, highlighting its clinical significance beyond the aortic valve.
Abstract:
Recently it was shown that subjects with aortic valve calcium (AVC) are at increased risk for future cardiovascular disease including stroke. We hypothesized that the increased risk of stroke may be due to an association with carotid artery atherosclerotic disease. Between 1995 and 1999 our laboratory made a diagnosis of AVC without significant stenosis in 3,949 patients. Of those, 279 patients without other cardiac structural exclusion criteria (148 men and 131 women; mean age 73 +/- 9 years, range 45 to 90) underwent carotid artery duplex ultrasound for various indications, and formed the study group. Age- and sex-matched patients without AVC (n = 277), who underwent carotid artery duplex ultrasound during the same period and for the same indications, served as the control group. Compared with the control group, the AVC group had a significantly higher prevalence of carotid stenosis (> 40% to 60%, 89% vs 78% [p < 0.001]; >60% to 80%, 43% vs 23% [p <0.001];and > 80% to 100%, 32%vs 14% [p < 0.001]). The AVC group had a similar, significantly higher prevalence of > or = 2-vessel disease and bilateral carotid stenosis (stenosis levels of > 20% to 40%, >40% to 60%, > 60% to 80%, and > 80% to 100%). In multivariate analysis, AVC, but not traditional risk factors, was the only independent predictor of severe carotid atherosclerotic disease (stenosis > 80% to 100%; p = 0.0001). Thus, there is a significant association between the presence of AVC and carotid atherosclerotic disease.
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