Relation of infra-renal abdominal aortic calcific deposits and cardiovascular events in patients with peripheral artery disease.
In patients with peripheral artery disease, aortic calcific deposits are a common finding. The aim of this study was to assess the association of infrarenal abdominal aortic calcific deposits with prospective cardiovascular events in patients with peripheral artery disease. A consecutive series of 213 patients who presented for investigation of abdominal aortic aneurysm or intermittent claudication were assessed using computed tomographic angiography. Infrarenal abdominal aortic calcific deposits were estimated using a previously defined highly reproducible semiautomated program. Patients were followed prospectively for a median of 2.8 years (interquartile range 1.7 to 3.6), and cardiovascular events were recorded. Kaplan-Meier and Cox proportional-hazards analysis were used to examine the association of calcific deposits with cardiovascular events. A total of 45 cardiovascular events occurred during follow-up, including nonfatal myocardial infarction (n = 23), coronary revascularization (n = 6), stroke (n = 3), below-knee amputation (n = 2), and cardiovascular death (n = 11). The incidence of cardiovascular events was 21.7%, 33.0%, and 36.9% for patients with mild (<400 mm(3)), intermediate (400 to 1,700 mm(3)), and severe (>1,700 mm(3)) abdominal aortic calcific deposits, respectively (p = 0.039). Calcific deposit volume >400 mm(3) (relative risk 2.8, 95% confidence interval 1.2 to 6.6) and coronary artery disease (relative risk 2.8, 95% confidence interval 1.4 to 5.6) were independently associated with increased cardiovascular events during follow-up. In conclusion, abdominal aortic calcific deposits are prognostic for cardiovascular events in patients with peripheral artery disease.
Parr
Adam
A
The Vascular Biology Unit, James Cook University, Townsville, Australia.
Buttner
Petra
P
Shahzad
Anwar
A
Golledge
Jonathan
J
D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D017544:Aortic Aneurysm, Abdominal / Q000150:complications; D001018:Aortic Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D002114:Calcinosis / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D007383:Intermittent Claudication / Q000150:complications; D016491:Peripheral Vascular Diseases / Q000150:complications*; D011379:Prognosis; D012307:Risk Factors; D014057:Tomography, X-Ray Computed