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Valvular calcification and risk of peripheral artery disease: the Multi-Ethnic Study of Atherosclerosis (MESA)

Parveen K Garg1, Petra Buzkova2, Zahra Meyghani3

  • 1Division of Cardiology, University of Southern California Keck School of Medicine, 1510 San Pablo St. Suite 322, Los Angeles, CA, USA.

European Heart Journal. Cardiovascular Imaging
|November 20, 2019
PubMed

Insights

Mitral annular calcification (MAC) is linked to a higher risk of developing clinical peripheral artery disease (PAD). Aortic valvular calcification (AVC) showed no significant association with PAD risk in this study.

Area of Science:

  • Cardiovascular Medicine
  • Atherosclerosis Research
  • Diagnostic Imaging

Background:

  • Cardiac valvular calcification, detected on routine imaging, may indicate heightened risk for peripheral artery disease (PAD).
  • Investigating the link between aortic valvular calcification (AVC) and mitral annular calcification (MAC) with clinical PAD and low ankle-brachial index (ABI) is crucial for early risk identification.

Purpose of the Study:

  • To determine the association between AVC and MAC and the risk of developing clinical PAD.
  • To assess the relationship between AVC and MAC and the incidence of a low ABI.

Main Methods:

  • Utilized cardiac computed tomography to measure AVC and MAC in 6778 participants from the Multi-Ethnic Study of Atherosclerosis.
  • Clinical PAD and incident low ABI were ascertained over median follow-up periods of 14 and 9.2 years, respectively.
  • Employed adjusted Cox proportional hazards and Poisson regression models to analyze associations.

Main Results:

  • Mitral annular calcification (MAC) was significantly associated with an increased risk of clinical PAD (HR 1.79; 95% CI 1.04-3.05).
  • No significant association was found between MAC and the risk of a low ABI (RR 1.28; 95% CI 0.75-2.19).
  • Aortic valvular calcification (AVC) did not show significant associations with the risk of clinical PAD or low ABI.

Conclusions:

  • Mitral annular calcification (MAC) is associated with an elevated risk of developing clinical peripheral artery disease (PAD).
  • Further research is warranted to confirm these findings and explore MAC's predictive value as a PAD risk marker.
Abstract

Keywords:
ankle–brachial indexcomputed tomographymitral annular calcificationperipheral arterial diseaserisk factors

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