Aortic valve calcification predicts all-cause mortality independent of coronary calcification and severe stenosis
| Autor: | Hyung J. Chun, Jared L. Christensen, Elena Aikawa, Joshua M Berus, Gaurav Choudhary, Hojune E Chung, Sydney Tan, Dhairyasheel S Ghosalkar, Alice Chu, Reema Qureshi, Nishant R. Shah, Wenzheng Yu, Alan R. Morrison, Wen-Chih Wu |
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| Rok vydání: | 2020 |
| Předmět: |
Male
0301 basic medicine medicine.medical_specialty Lung Neoplasms Population Constriction Pathologic Disease 030204 cardiovascular system & hematology Article 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine Clinical endpoint Humans Myocardial infarction education Early Detection of Cancer Retrospective Studies education.field_of_study business.industry food and beverages Aortic Valve Stenosis medicine.disease 030104 developmental biology Aortic Valve Aortic valve stenosis Coronary artery calcification Cardiology Female Aortic valve calcification Cardiology and Cardiovascular Medicine business Lung cancer screening |
| Zdroj: | Atherosclerosis |
| ISSN: | 0021-9150 |
| DOI: | 10.1016/j.atherosclerosis.2020.06.019 |
| Popis: | BACKGROUND AND AIMS: Calcific aortic valve disease is highly prevalent in patients with significant smoking history and is a marker of atherosclerosis. The aim of this study was to define the prognostic value of aortic valve calcification (AVC) derived from low dose, lung cancer screening computed tomography (LCSCT) for all-cause mortality in this higher risk population. METHODS: This is a single site, retrospective analysis of 1529 moderate-to-high atherosclerotic cardiovascular risk U.S. veterans (65 years [IQI: 61, 68] years; 96% male), who underwent clinically indicated LCSCT. CTs were scored for aortic valve calcification (AVC) and coronary artery calcification (CAC). The primary endpoint was all-cause mortality and secondary endpoints were nonfatal myocardial infarction (MI) and nonfatal cerebrovascular accident (CVA). RESULTS: Over 4-year follow-up, 227 patients (15%) died, 112 patients (7%) had nonfatal MI, and 52 patients (3%) had nonfatal CVA. AVC was predictive of all-cause mortality (HR per 100: 1.041 [1.030–1.052], p < 0.001), and this association remained significant after multivariate adjustment for traditional atherosclerotic risk factors, including CAC (1.021 [1.007–1.036], p = 0.003). After excluding patients with severe aortic stenosis (AS) or severe AVC (≥1274 AU in women and ≥2065 AU in men), in a subset of 765 patients who had echocardiograms, this association remained significant after multivariate analysis (HR per 100: 1.052 [1.010–1.095], p = 0.014). Despite controlling for CAC in the models, AVC was still associated with MI (HR per 100: 1.021 [1.004–1.039], p = 0.017) and with CVA (HR per 100: 1.027 [1.002–1.051], p = 0.032). CONCLUSIONS: Scoring AVC derived from LCSCT is predictive of mortality, nonfatal MI, and nonfatal CVA in patients at known risk for cardiovascular disease, independent of coronary calcification or severe aortic valve stenosis. |
| Databáze: | OpenAIRE |
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