title: Mitral and aortic annular calcifications and cerebrovascular ischemic episodes in patients with coronary artery disease.
abstract: BACKGROUND
  Atherosclerosis is a systemic pathological process involving the whole arterial bed. Valvular calcifications are associated with cardiovascular risk factors. Significant carotid stenosis accounts for approximately 20% of cerebrovascular ischemic episodes.
  
  
  OBJECTIVE
  The aim of the study was to assess the relationship between mitral and aortic annular calcifications, increased carotid intima-media thickness (CIMT), and incidence of cerebrovascular ischemic episodes.
  
  
  METHODS
  A total of 127 patients with angiographically confirmed coronary artery disease (68 men and 59 women; aged 74 (33-87) years) were divided into 4 groups: with aortic valve calcifications (AVCs), mitral annular calcifications (MACs), both aortic valve and mitral annular calcifications (AMVCs), and no valvular calcifications (no-VCs), based on the echocardiographic assessment of the mitral and aortic valves. CIMT and the presence of atherosclerotic plaques were evaluated by carotid ultrasonography. A history of cerebrovascular ischemic episodes was obtained.
  
  
  RESULTS
  The combined prevalence of mitral or aortic valve calcifications in the study population was 59% (AVCs, 55%; MACs, 24%; and AMVCs, 21%). CIMT was significantly increased in the MAC and AMVC groups (P <0.05 for MACs; P <0.01 for AMVCs). Ischemic stroke was more common in the AVC group (P <0.05), while the MAC group had a higher incidence of carotid plaques (P <0.05), transient ischemic attacks (TIA; P <0.05), and strokes (P <0.05) as compared with the no-VC group. In multivariate analysis, only MACs remained independently associated with increased CIMT.
  
  
  CONCLUSIONS
  In patients with coronary artery disease, MACs are independently associated with increased CIMT but not with TIA or stroke. There is no relationship between the concomitant presence of mitral and aortic calcifications and carotid atherosclerosis.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Mostowik
authors.forename: Ilona
authors.initials: I
authors.lastname: Palka
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Gajos
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Nessler
authors.forename: Andrzej
authors.initials: A
authors.lastname: Gackowski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000473:pathology*; D001161:Arteriosclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D002339:Carotid Arteries / Q000473:pathology; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000473:pathology*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000473:pathology*; D012307:Risk Factors; D014463:Ultrasonography