Abdominal aortic calcification detected by dual X-ray absorptiometry: A strong predictor for cardiovascular events.
BACKGROUND
Vertebral fracture assessment (VFA) using dual-energy X-ray absorptiometry can visualize abdominal aortic calcification (AAC). AAC correlates with total atherosclerosis burden. We questioned whether VFA-detected AAC could be used for cardiovascular risk assessment.


METHODS
VFA images of 2,500 subjects were evaluated to detect and score AAC (n = 164). A random age- and gender-matched set of subjects (n = 325) without AAC served as control group. Patients with prior cardiovascular disease or procedures were excluded. Base-line cardiovascular risk factors and further cardiovascular events were checked. Design-based Cox regression analysis was used to examine the prognostic value of AAC for cardiovascular outcomes.


RESULTS
AAC-positive subjects were divided into two groups: low-AAC (score 1–3), and high-AAC group (score > 3). Mean age in the groups was 68, 68, and 71 years, percentage of females was 64.4%, 61%, and 66.1%, and the proportion of cardiovascular events within groups was 1.5%, 6.7%, and 11.9% in control, low-AAC, and high-AAC groups, respectively. Age- and gender-adjusted as well as multivariable analysis showed a significant, higher risk for cardiovascular events incidence in AAC-positive, low-AAC, and high-AAC when compared to the control group.


CONCLUSIONS
AAC assessed with routine VFA was shown to be a strong predictor for cardiovascular events.
Golestani
Reza
R
Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the Netherlands.
Tio
René
R
Zeebregts
Clark J
CJ
Zeilstra
Aafke
A
Dierckx
Rudi A
RA
Boersma
Hendrikus H
HH
Hillege
Hans L
HL
Slart
Riemer H J A
RH
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging* / Q000473:pathology*; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models