Related Experiment Video
Updated: May 3, 2026
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Beyond Framingham risk factors and coronary calcification: does aortic valve calcification improve risk prediction?
Hagen Kälsch1, Nils Lehmann2, Amir A Mahabadi1
1Department of Cardiology, West-German Heart Center Essen, University Duisburg-Essen, Essen, Germany.
Insights
Aortic valve calcification (AVC) is linked to coronary and cardiovascular disease (CVD) events, independent of traditional risk factors. However, AVC does not improve cardiovascular risk prediction when combined with Framingham risk factors and coronary artery calcification (CAC).
Area of Science:
- Cardiology
- Atherosclerosis Research
- Medical Imaging
Background:
- Aortic valve calcification (AVC) is recognized as a manifestation of atherosclerosis.
- The study investigates the added value of AVC in cardiovascular risk prediction.
- Existing models include Framingham risk factors and coronary artery calcification (CAC).
Purpose of the Study:
- To determine if AVC improves cardiovascular risk prediction beyond established factors.
- To assess the independent association of AVC with coronary events, stroke, and CVD events.
- To evaluate the incremental predictive value of AVC when added to Framingham risk factors and CAC.
Main Methods:
- Utilized data from 3944 participants in the Heinz Nixdorf Recall Study.
- Assessed coronary events, stroke, and cardiovascular disease (CVD) events over a mean follow-up of 9.1 years.
- Employed CT scans for AVC quantification and Cox regression and Harrell's C for risk prediction analysis.
Main Results:
- Higher AVC scores correlated significantly with increased incidence of coronary and CVD events.
- AVC demonstrated independent association with coronary and CVD events after adjusting for Framingham risk factors.
- Adding AVC to models with Framingham risk factors and CAC did not significantly improve Harrell's C indices for event prediction.
Conclusions:
- Aortic valve calcification is independently associated with increased risk of coronary and CVD events.
- AVC does not enhance cardiovascular event prediction when traditional risk factors and CAC are already considered.
- Current risk prediction models incorporating Framingham factors and CAC are not significantly improved by the addition of AVC.
Background:
Aortic valve calcification (AVC) is considered a manifestation of atherosclerosis. In this study, we investigated whether AVC adds to cardiovascular risk prediction beyond Framingham risk factors and coronary artery calcification (CAC).
Methods:
A total of 3944 subjects from the population based Heinz Nixdorf Recall Study (59.3±7.7 years; 53% females) were evaluated for coronary events, stroke, and cardiovascular disease (CVD) events (including all plus CV death) over 9.1±1.9 years. CT scans were performed to quantify AVC. Cox proportional hazards regressions and Harrell's C were used to examine AVC as event predictor in addition to risk factors and CAC.
Results:
During follow-up, 138 (3.5%) subjects experienced coronary events, 101 (2.6%) had a stroke, and 257 (6.5%) experienced CVD events. In subjects with AVC>0 versus AVC=0 the incidence of coronary events was 8.0% versus 3.0% (p<0.001) and the incidence of CVD events was 13.0% versus 5.7% (p<0.001). The frequency of events increased significantly with increasing AVC scores (p<0.001). After adjustment for Framingham risk factors, high AVC scores (3rd tertile) remained independently associated with coronary events (HR 2.21, 95% CI 1.28 to 3.81) and CVD events (HR 1.67, 95% CI 1.08 to 2.58). After further adjustment for CAC score, HRs were attenuated (coronary events 1.55, 95% CI 0.89 to 2.69; CVD events 1.29, 95% CI 0.83 to 2.00). When adding AVC to the model containing traditional risk factors and CAC, Harrell's C indices did not increase for coronary events (from 0.744 to 0.744) or CVD events (from 0.759 to 0.759).
Conclusions:
AVC is associated with incident coronary and CVD events independent of Framingham risk factors. However, AVC fails to improve cardiovascular event prediction over Framingham risk factors and CAC.
More Related Videos
04:30Investigating Aortic Valve Calcification via Isolation and Culture of T Lymphocytes using Feeder Cells from Irradiated Buffy Coat
Published on: February 4, 2021
05:47Isolation of Mouse Interstitial Valve Cells to Study the Calcification of the Aortic Valve In Vitro
Published on: May 10, 2021
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
01:30Coronary Artery Disease I: Introduction
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests