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Relationship of aortic valve calcification with coronary artery calcium severity: the Multi-Ethnic Study of
Khurram Nasir1, Ronit Katz, Mouaz Al-Mallah
1Division of Cardiology, Blalock 524 C, Johns Hopkins University, 600N Wolfe Street, Baltimore, MD 21287, USA. knasir1@jhmi.edu
Insights
Aortic valve calcification (AVC) is independently linked to coronary artery calcium (CAC) severity. Higher CAC scores significantly increase the likelihood of developing AVC, highlighting a shared atherosclerotic pathway.
Area of Science:
- Cardiovascular Imaging
- Atherosclerosis Research
- Calcium Scoring
Background:
- Aortic valve calcification (AVC) and atherosclerosis share common underlying mechanisms.
- Understanding the relationship between these conditions is crucial for cardiovascular risk assessment.
Purpose of the Study:
- To investigate the association between the severity of coronary artery calcium (CAC) and the presence of aortic valve calcification (AVC).
- To evaluate this relationship within the Multi-Ethnic Study of Atherosclerosis (MESA) cohort.
Main Methods:
- Utilized non-contrast cardiac computed tomography to assess AVC and CAC in 6809 participants (aged 45-84).
- Employed relative risk regression to model AVC probability based on CAC presence and severity categories (0, 1-99, 100-399, ≥400).
Main Results:
- Prevalence of AVC was 13% and CAC was 50%.
- AVC prevalence increased with CAC severity: 5% (no CAC), 14% (CAC 1-99), 25% (CAC 100-399), and 38% (CAC ≥400).
- Adjusted analysis showed a significant independent association between higher CAC severity and increased AVC risk (PR 1.83 for mild CAC, 3.36 for severe CAC).
Conclusions:
- Aortic valve calcification is independently associated with increasing coronary artery calcium severity.
- Findings suggest shared risk factors and pathways between AVC and coronary atherosclerosis.
Background:
Aortic valve calcification (AVC) and atherosclerosis share causative and pathologic features.
Objective:
We evaluated the relationship between AVC and coronary artery calcium (CAC) severity in the Multi-Ethnic Study of Atherosclerosis (MESA).
Methods:
Men and women aged 45-84 years (n=6809; mean age, 62 years) were studied. The presence and burden of AVC and CAC were determined by noncontrast cardiac computed tomography. Relative risk regression was used to model the probability of AVC as a function of CAC > 0 as well as CAC categories (0, 1-99, 100-399, and > or = 400) with the reference group being CAC=0.
Results:
The prevalence of AVC and CAC was 13% and 50%, respectively. Among those without CAC, the prevalence of AVC was 5% and increased across levels of CAC severity such that 14%, 25%, and 38% had AVC with increasing CAC scores of 1-99, 100-399, and > or = 400, respectively (P for trend<0.0001). After controlling for patient demographic factors and cardiovascular risk factors, the prevalence ratio of AVC among those with mild CAC (1-99) was 1.83 (95% CI, 1.45-2.31) and increased to 3.36 (95% CI, 2.56-4.42) for CAC > or = 400. Similar statistically significant increased risk of AVC was found when CAC was assessed as a continuous variable.
Conclusion:
Our study shows that AVC is independently associated with increasing severity of CAC.
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