title: Abdominal aortic calcification detected by dual X-ray absorptiometry: A strong predictor for cardiovascular events.
abstract: 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.
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the Netherlands.
authors.forename: Reza
authors.initials: R
authors.lastname: Golestani
authors.forename: René
authors.initials: R
authors.lastname: Tio
authors.forename: Clark J
authors.initials: CJ
authors.lastname: Zeebregts
authors.forename: Aafke
authors.initials: A
authors.lastname: Zeilstra
authors.forename: Rudi A
authors.initials: RA
authors.lastname: Dierckx
authors.forename: Hendrikus H
authors.initials: HH
authors.lastname: Boersma
authors.forename: Hans L
authors.initials: HL
authors.lastname: Hillege
authors.forename: Riemer H J A
authors.initials: RH
authors.lastname: Slart
mesh_terms: 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