Calcification of the thoracic aorta as detected by spiral computed tomography among stable angina pectoris patients: association with cardiovascular events and death.
BACKGROUND
Calcification of the thoracic aorta is associated with atherosclerotic risk factors, yet its pathogenesis and clinical implications are not yet elucidated. The goal of the present study was to assess whether thoracic aorta calcification is associated with an increased risk of cardiovascular events and death in patients with stable angina pectoris.


RESULTS
A prospective cohort of 361 stable angina pectoris patients (307 men, 54 women; age range, 37 to 83 years) underwent chest spiral computed tomography and were evaluated for aortic calcification. We recorded the incidence of cardiovascular events and death during a 4.5- to 6-year follow-up. Aortic calcification was documented in 253 patients (70% of patients; 213 men, 40 women). Patients with aortic calcification were older (mean age, 65+/-7 versus 55+/-9 years; P<0.001), and fewer were classified as smokers (13% versus 26%; P=0.014) compared with patients without aortic calcification. Significant correlation was found between patients with and those without aortic calcification for the presence of aortic valve calcification (28% versus 11%; P<0.001), mitral annulus calcification (29% versus 4%; P<0.001), and coronary calcification as expressed by coronary calcium score. (P<0.001). During 4.5 to 6 years of follow-up, 19 patients died, all of whom were in the aortic calcification group. Age-adjusted hazard ratios for total events and cardiovascular events by aortic calcification were 2.84 (95% CI, 1.52 to 5.30; P=0.001) and 2.70 (95% CI, 1.33 to 5.47; P=0.006), respectively. In multivariable analysis, hazard ratios for total events and cardiovascular events were 2.79 (95% CI, 1.46 to 5.20; P=0.002) and 4.65 (95% CI, 1.19 to 18.26; P=0.028), respectively.


CONCLUSIONS
Calcification of the thoracic aorta is age related and associated with coronary calcification and valvular calcification. Thoracic aortic calcification is associated with an increased risk of death and cardiovascular disease.
Eisen
Alon
A
Cardiac Rehabilitation Institute, Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Tenenbaum
Alexander
A
Koren-Morag
Nira
N
Tanne
David
D
Shemesh
Joseph
J
Imazio
Massimo
M
Fisman
Enrique Z
EZ
Motro
Michael
M
Schwammenthal
Ehud
E
Adler
Yehuda
Y
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000401:mortality* / Q000601:surgery; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging*; D001018:Aortic Diseases / Q000000981:diagnostic imaging* / Q000401:mortality*; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000401:mortality*; D001026:Coronary Artery Bypass / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000601:surgery; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology; D036542:Tomography, Spiral Computed