Carmine Mazzone1, Gianni Cioffi2, Concetta Di Nora3, Giulia Barbati4, Federica Guidetti5, Pompilio Faggiano6, Nicola Gaibazzi7, Giorgio Faganello1, Endria Casanova Borca1, Andrea Di Lenarda1. 1. Cardiovascular Centre, ASUITS, Maggiore Hospital, Trieste, Italy. 2. Villa Bianca Hospital, Department of Cardiology, Trento, Italy. 3. Department of Cardiology, University of Trieste, Trieste, Italy. Electronic address: concetta.dinora@gmail.com. 4. Department of Statistics, University of Trieste, Trieste, Italy. 5. Department of Cardiology, University Hospital, Zurich, Switzerland. 6. Spedali Civili, Department of Cardiology, Brescia, Italy. 7. Department of Cardiology, University Hospital, Parma.
Abstract
BACKGROUND: Increasing evidence exists regarding calcium detected in aortic cusps and/or mitral annulus (AOC_MAC) at transthoracic echocardiogram as a predictor of cardiovascular (CV) events and mortality. PURPOSE: To verify whether AOC_MAC has a prognostic role in the setting of primary prevention independently of the presence of atrial fibrillation (AF). METHODS: All subjects consecutively referred from January 2011 to October 2014 to the Cardiovascular Centre for CV risk assessment in primary prevention were selected. AOC_MAC was assessed by transthoracic echocardiography. Primary study endpoint was a composite of CV hospitalizations/all-cause death. RESULTS: The 1389 study patients were 70 years old, 43% males, 24% had diabetes mellitus, 75% arterial hypertension, 56% dyslipidaemia. Of all, 997 (72%) were in sinus rhythm (SR), 392 (28%) in AF. Patients with AF were older and more frequently males, with larger atria than SR subjects. During a median follow-up of 32 months, 165 patients (12%) were hospitalized for CV cause, 68 (5%) died. The primary endpoint occurred more frequently in patients with than without AOC_MAC (18% vs 11%, p < 0.001). AF patients showed higher event-rate compared with patients in SR (20% vs 10%, respectively; p < 0.01). AOC_MAC emerged as an independent prognosticator of primary endpoint in SR patients (HR 1.74 [1.07-2.82], p = 0.02), together with increasing age and left ventricular hypertrophy, while AOC_MAC had no prognostic relevance in AF patients. CONCLUSIONS: In subjects with multiple CV risk factors assessed in primary prevention, the presence of AF nullifies the prognostic power of AOC_MAC, on the contrary robustly confirmed in SR patients.
BACKGROUND: Increasing evidence exists regarding calcium detected in aortic cusps and/or mitral annulus (AOC_MAC) at transthoracic echocardiogram as a predictor of cardiovascular (CV) events and mortality. PURPOSE: To verify whether AOC_MAC has a prognostic role in the setting of primary prevention independently of the presence of atrial fibrillation (AF). METHODS: All subjects consecutively referred from January 2011 to October 2014 to the Cardiovascular Centre for CV risk assessment in primary prevention were selected. AOC_MAC was assessed by transthoracic echocardiography. Primary study endpoint was a composite of CV hospitalizations/all-cause death. RESULTS: The 1389 study patients were 70 years old, 43% males, 24% had diabetes mellitus, 75% arterial hypertension, 56% dyslipidaemia. Of all, 997 (72%) were in sinus rhythm (SR), 392 (28%) in AF. Patients with AF were older and more frequently males, with larger atria than SR subjects. During a median follow-up of 32 months, 165 patients (12%) were hospitalized for CV cause, 68 (5%) died. The primary endpoint occurred more frequently in patients with than without AOC_MAC (18% vs 11%, p < 0.001). AFpatients showed higher event-rate compared with patients in SR (20% vs 10%, respectively; p < 0.01). AOC_MAC emerged as an independent prognosticator of primary endpoint in SR patients (HR 1.74 [1.07-2.82], p = 0.02), together with increasing age and left ventricular hypertrophy, while AOC_MAC had no prognostic relevance in AFpatients. CONCLUSIONS: In subjects with multiple CV risk factors assessed in primary prevention, the presence of AF nullifies the prognostic power of AOC_MAC, on the contrary robustly confirmed in SR patients.
Authors: Beata Ceynowa-Sielawko; Maciej T Wybraniec; Aleksandra Topp-Zielińska; Aleksander Maciąg; Dawid Miśkowiec; Paweł Balsam; Maciej Wójcik; Wojciech Wróbel; Michał M Farkowski; Edyta Ćwiek-Rębowska; Krzysztof Ozierański; Robert Błaszczyk; Karolina Bula; Tomasz Dembowski; Michał Peller; Bartosz Krzowski; Wojciech Wańha; Marek Koziński; Jarosław D Kasprzak; Hanna Szwed; Katarzyna Mizia-Stec; Marek Szołkiewicz Journal: Int J Environ Res Public Health Date: 2022-04-17 Impact factor: 3.390
Authors: Cilie C van 't Klooster; Hendrik M Nathoe; J Hjortnaes; Michiel L Bots; Ivana Isgum; Nikolas Lessmann; Yolanda van der Graaf; Tim Leiner; Frank L J Visseren Journal: Int J Cardiol Heart Vasc Date: 2020-03-17