Hagen Kälsch1, Nils Lehmann2, Amir A Mahabadi1, Marcus Bauer1, Kaffer Kara1, Patricia Hüppe1, Susanne Moebus2, Stefan Möhlenkamp3, Nico Dragano4, Axel Schmermund5, Andreas Stang6, Karl-Heinz Jöckel2, Raimund Erbel1. 1. Department of Cardiology, West-German Heart Center Essen, University Duisburg-Essen, Essen, Germany. 2. Biometry, and Epidemiology, Institute of Medical Informatics, University Duisburg-Essen, Essen, Germany. 3. Department of Cardiology, Krankenhaus Bethanien, Moers, Germany. 4. Medical Faculty, Centre for Health and Society, Institute of Medical Sociology, University Clinic Düsseldorf, Düsseldorf, Germany. 5. Cardioangiological Center Bethanien, Frankfurt/Main, Germany. 6. Medical Faculty, Institute of Clinical Epidemiology, University Halle-Wittenberg, Halle, Germany.
Abstract
BACKGROUND: Aortic valve calcification (AVC) is considered a manifestation of atherosclerosis. In this study, we investigated whether AVC adds to cardiovascular risk prediction beyond Framingham risk factors and coronary artery calcification (CAC). METHODS: A total of 3944 subjects from the population based Heinz Nixdorf Recall Study (59.3±7.7 years; 53% females) were evaluated for coronary events, stroke, and cardiovascular disease (CVD) events (including all plus CV death) over 9.1±1.9 years. CT scans were performed to quantify AVC. Cox proportional hazards regressions and Harrell's C were used to examine AVC as event predictor in addition to risk factors and CAC. RESULTS: During follow-up, 138 (3.5%) subjects experienced coronary events, 101 (2.6%) had a stroke, and 257 (6.5%) experienced CVD events. In subjects with AVC>0 versus AVC=0 the incidence of coronary events was 8.0% versus 3.0% (p<0.001) and the incidence of CVD events was 13.0% versus 5.7% (p<0.001). The frequency of events increased significantly with increasing AVC scores (p<0.001). After adjustment for Framingham risk factors, high AVC scores (3rd tertile) remained independently associated with coronary events (HR 2.21, 95% CI 1.28 to 3.81) and CVD events (HR 1.67, 95% CI 1.08 to 2.58). After further adjustment for CAC score, HRs were attenuated (coronary events 1.55, 95% CI 0.89 to 2.69; CVD events 1.29, 95% CI 0.83 to 2.00). When adding AVC to the model containing traditional risk factors and CAC, Harrell's C indices did not increase for coronary events (from 0.744 to 0.744) or CVD events (from 0.759 to 0.759). CONCLUSIONS: AVC is associated with incident coronary and CVD events independent of Framingham risk factors. However, AVC fails to improve cardiovascular event prediction over Framingham risk factors and CAC. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND:Aortic valve calcification (AVC) is considered a manifestation of atherosclerosis. In this study, we investigated whether AVC adds to cardiovascular risk prediction beyond Framingham risk factors and coronary artery calcification (CAC). METHODS: A total of 3944 subjects from the population based Heinz Nixdorf Recall Study (59.3±7.7 years; 53% females) were evaluated for coronary events, stroke, and cardiovascular disease (CVD) events (including all plus CV death) over 9.1±1.9 years. CT scans were performed to quantify AVC. Cox proportional hazards regressions and Harrell's C were used to examine AVC as event predictor in addition to risk factors and CAC. RESULTS: During follow-up, 138 (3.5%) subjects experienced coronary events, 101 (2.6%) had a stroke, and 257 (6.5%) experienced CVD events. In subjects with AVC>0 versus AVC=0 the incidence of coronary events was 8.0% versus 3.0% (p<0.001) and the incidence of CVD events was 13.0% versus 5.7% (p<0.001). The frequency of events increased significantly with increasing AVC scores (p<0.001). After adjustment for Framingham risk factors, high AVC scores (3rd tertile) remained independently associated with coronary events (HR 2.21, 95% CI 1.28 to 3.81) and CVD events (HR 1.67, 95% CI 1.08 to 2.58). After further adjustment for CAC score, HRs were attenuated (coronary events 1.55, 95% CI 0.89 to 2.69; CVD events 1.29, 95% CI 0.83 to 2.00). When adding AVC to the model containing traditional risk factors and CAC, Harrell's C indices did not increase for coronary events (from 0.744 to 0.744) or CVD events (from 0.759 to 0.759). CONCLUSIONS: AVC is associated with incident coronary and CVD events independent of Framingham risk factors. However, AVC fails to improve cardiovascular event prediction over Framingham risk factors and CAC. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Wael A AlJaroudi; Andrew J Einstein; Farooq A Chaudhry; Steven G Lloyd; Fadi G Hage Journal: J Nucl Cardiol Date: 2015-02-20 Impact factor: 5.952
Authors: Tom Kai Ming Wang; Scott D Flamm; Paul Schoenhagen; Brian P Griffin; L Leonardo Rodriguez; Richard A Grimm; Bo Xu Journal: Radiol Cardiothorac Imaging Date: 2021-08-26
Authors: Amélie Paquin; Ons Marsit; Valérie Deschênes; Dounia Rouabhia; Sandra Hadjadj; Marine Clisson; Charlotte Robitaille; Elena Aikawa; Robert A Levine; Philippe Pibarot; Marie-Annick Clavel; Jonathan Beaudoin Journal: Open Heart Date: 2022-06
Authors: Panteha Rezaeian; P Elliott Miller; Sabina A Haberlen; Aryabod Razipour; Hossein Bahrami; Romeo Castillo; Mallory D Witt; Lawrence Kingsley; Frank J Palella; Rine Nakanishi; Suguru Matsumoto; Anas Alani; Lisa P Jacobson; Wendy S Post; Matthew J Budoff Journal: J Cardiovasc Comput Tomogr Date: 2016-02-27
Authors: Donghee Han; Rhanderson Cordoso; Seamus Whelton; Alan Rozanski; Matthew J Budoff; Michael D Miedema; Khurram Nasir; Leslee J Shaw; John A Rumberger; Heidi Gransar; Zeina Dardari; Roger S Blumenthal; Michael J Blaha; Daniel S Berman Journal: Eur Heart J Cardiovasc Imaging Date: 2021-10-19 Impact factor: 6.875