title: Comparison of Atherosclerotic Calcification in Major Vessel Beds on the Risk of All-Cause and Cause-Specific Mortality: The Rotterdam Study.
abstract: BACKGROUND
  Atherosclerosis is a major contributor to global morbidity and mortality. Although atherosclerosis is a systemic disease, its burden varies considerably across vessel beds, which may translate into differences in mortality risk.
  
  
  RESULTS
  From 2003 to 2006, a sample of 2408 elderly participants (mean age, 69.6±6.7 years; 52.4% female) from the population-based Rotterdam Study underwent computed tomography to quantify atherosclerotic calcification in the coronary arteries, aortic arch, extracranial, and intracranial internal carotid arteries. Mortality follow-up was complete until January 1, 2012. We investigated associations of calcification in each vessel bed with mortality using Cox regression, adjusting for age, sex, and cardiovascular risk factors. Next, all vessel beds were included into 1 model to investigate independency of associations. Finally, we investigated the predictive value of calcification beyond the predictors included in the Pooled Cohort equations. During 15 775 person-years of follow-up, 283 participants died. Larger calcification volumes in all vessels were related to higher risks of all-cause mortality, cardiovascular, and noncardiovascular mortality, independent of cardiovascular risk factors. Most prominent associations were found for aortic arch calcification and cardiovascular mortality (age- and sex-adjusted hazard ratio per 1-SD increase 2.72 [95% confidence interval, 1.85-4.02]), independent of calcification elsewhere (hazard ratio, 1.75 (95% confidence interval, 1.13-2.72]). Calcification in any vessel improved prediction for all 3 outcomes.
  
  
  CONCLUSIONS
  Atherosclerotic load in major vessel beds is associated with an increased risk of death. In particular, aortic arch calcification volume yields unique information with regard to mortality in addition to atherosclerosis in other vessel beds.
authors.affiliation: From the Departments of Radiology (D.B., A.L., M.W.V., M.A.I.), Epidemiology (D.B., M.J.G.L., M.K., A.H., O.H.F., M.W.V., M.A.I.), Cardiology (M.J.G.L.), and Neurology (M.A.I.), Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Daniel
authors.initials: D
authors.lastname: Bos
authors.affiliation: From the Departments of Radiology (D.B., A.L., M.W.V., M.A.I.), Epidemiology (D.B., M.J.G.L., M.K., A.H., O.H.F., M.W.V., M.A.I.), Cardiology (M.J.G.L.), and Neurology (M.A.I.), Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Maarten J G
authors.initials: MJ
authors.lastname: Leening
authors.affiliation: From the Departments of Radiology (D.B., A.L., M.W.V., M.A.I.), Epidemiology (D.B., M.J.G.L., M.K., A.H., O.H.F., M.W.V., M.A.I.), Cardiology (M.J.G.L.), and Neurology (M.A.I.), Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Maryam
authors.initials: M
authors.lastname: Kavousi
authors.affiliation: From the Departments of Radiology (D.B., A.L., M.W.V., M.A.I.), Epidemiology (D.B., M.J.G.L., M.K., A.H., O.H.F., M.W.V., M.A.I.), Cardiology (M.J.G.L.), and Neurology (M.A.I.), Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: From the Departments of Radiology (D.B., A.L., M.W.V., M.A.I.), Epidemiology (D.B., M.J.G.L., M.K., A.H., O.H.F., M.W.V., M.A.I.), Cardiology (M.J.G.L.), and Neurology (M.A.I.), Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.affiliation: From the Departments of Radiology (D.B., A.L., M.W.V., M.A.I.), Epidemiology (D.B., M.J.G.L., M.K., A.H., O.H.F., M.W.V., M.A.I.), Cardiology (M.J.G.L.), and Neurology (M.A.I.), Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Aad
authors.initials: A
authors.lastname: van der Lugt
authors.affiliation: From the Departments of Radiology (D.B., A.L., M.W.V., M.A.I.), Epidemiology (D.B., M.J.G.L., M.K., A.H., O.H.F., M.W.V., M.A.I.), Cardiology (M.J.G.L.), and Neurology (M.A.I.), Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Meike W
authors.initials: MW
authors.lastname: Vernooij
authors.affiliation: From the Departments of Radiology (D.B., A.L., M.W.V., M.A.I.), Epidemiology (D.B., M.J.G.L., M.K., A.H., O.H.F., M.W.V., M.A.I.), Cardiology (M.J.G.L.), and Neurology (M.A.I.), Erasmus MC, Rotterdam, The Netherlands. m.a.ikram@erasmusmc.nl.
authors.forename: M Arfan
authors.initials: MA
authors.lastname: Ikram
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000401:mortality*; D001027:Aortography / Q000379:methods; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000401:mortality*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000401:mortality*; D002343:Carotid Artery, Internal; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009426:Netherlands / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors
keywords: cardiovascular disease; computed tomography; epidemiology; mortality; risk factors