Relationship of aortic valve calcification with coronary artery calcium severity: the Multi-Ethnic Study of Atherosclerosis (MESA).
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.


CONCLUSIONS
Our study shows that AVC is independently associated with increasing severity of CAC.
Nasir
Khurram
K
Division of Cardiology, Blalock 524 C, Johns Hopkins University, 600N Wolfe Street, Baltimore, MD 21287, USA. knasir1@jhmi.edu
Katz
Ronit
R
Al-Mallah
Mouaz
M
Takasu
Junichiro
J
Shavelle
David M
DM
Carr
Jeffery J
JJ
Kronmal
Richard
R
Blumenthal
Roger S
RS
O'Brien
Kevin
K
Budoff
Matthew J
MJ
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000208:ethnology*; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000208:ethnology*; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000208:ethnology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D014481:United States / Q000208:ethnology