Objective-The goal of this study was to determine differences in risks for total and cause-specific mortality related to calcified atherosclerosis in different vascular beds. Methods and Results-A total of 4544 patients underwent computed tomography scans that were interrogated for calcium in different vascular beds. Mortality assessment was conducted by death certificate adjudication. At baseline, the mean age was 56.8 years, and 43% were female. After an average of 7.8 years, there were 163 deaths. With full adjustment, the presence of calcium in the thoracic aorta (hazard ratio [HR], 2.1; 95% confidence interval [CI], 1.2-3.5), carotids (HR, 1.60; CI, 1.1-2.5), and iliac (HR, 1.67; CI, 1.0 -2.9) arteries were associated with total mortality, whereas the presence of coronary calcium was associated with cardiovascular disease (CVD) mortality (HR, 3.4; CI,). For severity of calcium burden, a 1-SD increment in the iliac arteries was the strongest predictor for all types of mortality. C-statistics were not significantly larger when noncoronary vascular beds were added to models with CVD risk factors or CVD risk factors plus coronary artery calcium. Key Words: calcification Ⅲ coronary artery disease Ⅲ electron beam computed tomography Ⅲ outcomes Ⅲ peripheral arterial disease C oronary artery calcium (CAC) is a significant predictor of future cardiac events independent of traditional risk factors. 1 When added to the traditional cardiovascular disease (CVD) risk factors, CAC improves the ability to correctly classify individual risk for incident CVD. 2 Similarly, the presence of calcified atherosclerosis in the thoracic aorta is independently associated with total mortality, 3 with earlier studies showing that the presence of calcified atherosclerosis of the abdominal aorta is associated with incident fatal and nonfatal CVD. 4 To our knowledge, no study has examined the association between calcified atherosclerosis in 5 distinct vascular beds and incident mortality. In this report, we present results of a study that tested the ability of calcified atherosclerosis from computed tomography (CT) in the carotid, coronary, thoracic aorta, abdominal aorta, and iliac vascular beds to predict incident total, CVD, and non-CVD mortality. From November 30, 2000, to July 30, 2003 consecutive patients underwent whole-body CT scanning as an adjunct to their preventive health care at a university-affiliated disease prevention center in San Diego, California. Most patients were asymptomatic and either self-referred or were referred on the recommendation of their personal physician. Participants completed a detailed health history questionnaire that collected information on hypertension, diabetes, high cholesterol, smoking, medications, family history of coronary heart disease, diet, exercise, and prior surgeries. The Human Research Protection Program at the University of California at San Diego approved the study protocol. Conclusion-The Methods Subjects ImagingCT was conducted using an Imatron C-150 scanner. At the time of the sc...

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