title: Risk Factors for the Development and Progression of Thoracic Aorta Calcification: The Multi-Ethnic Study of Atherosclerosis.
abstract: OBJECTIVE
  Vascular calcification independently predicts cardiovascular disease (CVD), and computed tomography (CT) is a useful tool to evaluate and quantify not only coronary but also thoracic aortic calcification (TAC). Previous TAC progression reports were limited to dialysis and renal transplant patients. This is the first study to evaluate TAC progression in a large multiethnic cohort without clinically evident CVD at entry.
  
  
  METHODS
  Non-contrast-enhanced cardiac CTs were obtained in 5886 of 6814 Multi-Ethnic Study of Atherosclerosis (MESA) participants (mean age, 62 years; 48% males; 40% white, 27% black, 21% Hispanic, and 12% Chinese). Baseline and follow-up TAC scores were derived.
  
  
  RESULTS
  Overall, 4308 (73%) participants had no detectable baseline TAC. Mean follow-up duration was 2.4 ± 0.8 years, during which 12% developed TAC. The overall incidence rate was 4.8%/year and was greater with age across gender and ethnic groups; TAC incidence was significantly lower in blacks than whites. After adjustment for follow-up duration, regression analyses showed age, systolic blood pressure, antihypertensives, and smoking were associated with incident TAC. A total of 1578 (27%) participants had TAC at baseline with a positive association between average annual TAC change and baseline age. Although the overall median change was 32.9 (-1.4 to 112.2) Agatston units, 27% showed an annual score change of ≥100 and blacks showed the lowest median across ethnic groups; 22.7 (-3 to 86.8). Age, systolic blood pressure, lipid-lowering medication, diabetes, and smoking were associated with TAC progression.
  
  
  CONCLUSIONS
  In MESA, traditional CV risk factors were related to both TAC incidence and progression. Blacks had the lowest incidence and median change across ethnic groups, consistent with previous findings for coronary calcification.
authors.affiliation: Department of Medicine, LA Biomedical Research Institute at Harbor, UCLA, 1124 West Carson St, Torrance, CA 90502.
authors.forename: George
authors.initials: G
authors.lastname: Youssef
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, Washington.
authors.forename: Mengye
authors.initials: M
authors.lastname: Guo
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, Washington.
authors.forename: Robyn L
authors.initials: RL
authors.lastname: McClelland
authors.affiliation: Department of Medicine, Harbor, UCLA, Los Angeles, California.
authors.forename: David M
authors.initials: DM
authors.lastname: Shavelle
authors.affiliation: Department of Medicine, LA Biomedical Research Institute at Harbor, UCLA, 1124 West Carson St, Torrance, CA 90502; Department of Cardiology, Johns Hopkins University, Baltimore, Maryland; Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, Florida; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, Florida; Department of Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida.
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
authors.affiliation: Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland; South Beach Preventive Cardiology, Miami, Florida.
authors.forename: Juan
authors.initials: J
authors.lastname: Rivera
authors.affiliation: Department of Radiology, Wake Forest University, Winston-Salem, North Carolina.
authors.forename: J Jeffrey
authors.initials: JJ
authors.lastname: Carr
authors.affiliation: Division of Radiology, University of California, Irvine, Irvine, California.
authors.forename: Nathan D
authors.initials: ND
authors.lastname: Wong
authors.affiliation: Department of Medicine, LA Biomedical Research Institute at Harbor, UCLA, 1124 West Carson St, Torrance, CA 90502. Electronic address: mbudoff@labiomed.org.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging*; D001794:Blood Pressure; D003920:Diabetes Mellitus / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014057:Tomography, X-Ray Computed; D061205:Vascular Calcification / Q000000981:diagnostic imaging* / Q000208:ethnology*; D044465:White People / Q000706:statistics & numerical data*
chemical_list: D000959:Antihypertensive Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Vascular calcification; cardiac computed tomography; cardiovascular events; progression; thoracic calcification