Abdominal Aortic Calcific Deposits Are an Important Predictor of Vascular Morbidity and Mortality

Wilson, Peter W.F.; Kauppila, Leena I.; O’Donnell, Christopher J.; Kiel, Douglas P.; Hannan, Marian T.; Polak, J.M.; Cupples, L. Adrienne

doi:10.1161/01.cir.103.11.1529

Cited by 556 publications

(460 citation statements)

References 30 publications

Supporting

Mentioning

427

Contrasting

Unclassified

Order By: Relevance

“…Again, the positive relationship of AAC with vascular disease was not a simple consequence of different lifestyle behaviours, increased levels of standard risk factors or decreased use of medications with potential beneficial vascular effects. As the current study was able to quantitate more precisely the extent of abdominal calcium and to determine the relationship of increasing burdens of AAC with CVD, these data add substantially to earlier reports that calcium seen in the abdominal aorta on standard radiographs may be a useful predictor of clinical CVD [26][27][28]. Moreover, this study demonstrates that AAC is also related to vascular disease in patients with type 2 diabetes.…”

Section: Discussionsupporting

confidence: 72%

Coronary artery and abdominal aortic calcification are associated with cardiovascular disease in type 2 diabetes

2005

View full text Add to dashboard Cite

Aims/hypothesis: The goals of this study were to determine whether coronary calcium is associated with the presence of clinical cardiovascular disease in individuals with type 2 diabetes and if the measurement of abdominal aortic calcium may have an independent or added benefit as a surrogate marker for clinical vascular disease. Methods: A cross-sectional study of subjects with type 2 diabetes enrolled in seven medical centres in the USA participating in a Veterans Affairs Cooperative Study of glycaemic control. Enrolled subjects included 309 veterans over 40 years of age with type 2 diabetes, with or without stable cardiovascular disease, who had inadequate glycaemic control (HbA 1 c>7.5%) on oral agents and/or insulin. The study assessed lifestyle behaviours, standard cardiovascular risk factors and coronary artery and abdominal aorta calcification by electron beam computed tomography. Results: Subjects with coronary artery or abdominal aorta calcification present had a strikingly higher prevalence of peripheral artery disease, coronary artery disease and all combined cardiovascular disease. Prevalence of each condition increased from 5-to 13-fold with increasing quintiles of coronary artery calcification and from 2-to 3-fold with increasing abdominal aorta calcification. These associations persisted after adjustment for lifestyle behaviours and standard cardiovascular risk factors. Conclusions/ interpretation: These results support the notion that vascular calcium in type 2 diabetes provides additional information beyond that of standard risk factors in identifying the presence of cardiovascular disease. Subclinical measures of atherosclerosis such as arterial calcification may help more precisely stratify these individuals and alert healthcare providers to those individuals who have particularly accelerated atherosclerosis.

show abstract

Section: Discussionsupporting

confidence: 72%

Coronary artery and abdominal aortic calcification are associated with cardiovascular disease in type 2 diabetes

2005

View full text Add to dashboard Cite

show abstract

“…(16)(17)(18)(19)(20)(21) Recently, we and others have reported that AAC can be measured on vertebral morphometric images obtained by dual-energy X-ray absorptiometry (DXA) and that the presence of AAC independently predicted incident MI, stroke, and cardiovascular events, even after adjusting for traditional cardiovascular risk factors. (22)(23)(24)(25) AAC also has been inversely associated with BMD in many studies.…”

Section: Introductionmentioning

confidence: 99%

Relationships between vascular calcification, calcium metabolism, bone density, and fractures

Wang

Bolland

Pelt

et al. 2010

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

Factors involved with calcium metabolism, such as serum calcium and phosphate and calcium intake, have been associated with vascular disease in different populations. We investigated whether this association is mediated via increased vascular calcification by assessing relationships between these factors and abdominal aortic calcification (AAC) and coronary artery calcification (CAC). A total of 1471 healthy postmenopausal women participated in a 5-year randomized, placebo-controlled trial of calcium 1 g/day, and 323 healthy middle-aged and older men participated in a 2-year randomized, placebo-controlled trial of calcium 600 or 1200 mg/day. AAC was assessed on vertebral morphometric images at baseline and follow-up. Based on computed tomography, 163 men had CAC assessed, on average, 1.5 years after study completion. In elderly women, AAC was positively related to serum calcium (p < .001), phosphate (p ¼ .04), and the calcium-phosphate product (p ¼ .003), but changes in AAC over time and incidence of cardiovascular events were not related to these variables. In middle-aged men, AAC and CAC were not consistently related to these variables. Neither dietary calcium intake nor calcium supplementation was associated with changes in the prevalence of AAC over time, and calcium supplementation also was not related to CAC scores in men. After adjusting for age, AAC was not associated with low bone mineral density (BMD) at baseline, changes in BMD over time, or fracture incidence. CAC also was not related to baseline BMD. In summary, serum calcium and phosphate are associated with AAC in older women, but dietary calcium intake and calcium supplementation were not associated with changes in AAC over 2 to 5 years. ß

show abstract

“…Arterial disease associated with ESRD is characterized by a high degree of intimal as well as medial calcification. Calcification has been shown to affect vascular elasticity (3) and mortality (4,5). The presence of calcification in patients with ESRD has been associated with increased stiffness of large capacity, elastic-type arteries like the aorta and the common carotid artery.…”

mentioning

confidence: 99%

Cardiovascular Calcifications in Uremic Patients

London

2003

Journal of the American Society of Nephrology

193

137

View full text Add to dashboard Cite

Abstract. Cardiovascular disease is the leading cause of mortality among patients with ESRD (chronic kidney disease stage 5). Left ventricular hypertrophy and arterial diseases are the two principal risk factors for cardiovascular mortality in hemodialysis patients. Epidemiologic studies show that damage to large conduit arteries contributes to morbidity and mortality in patients with chronic kidney disease. Atherosclerosis is primarily an intimal disease characterized by the presence of plaques and occlusive lesions. Although atherosclerosis is the most frequent underlying cause of cardiovascular disease in patients with ESRD, it represents only one form of structural response to metabolic and hemodynamic alterations that interfere with the process of aging. Arterial alterations in ESRD include nonocclusive arterial remodeling accompanying the growing hemodynamic burden and humoral abnormalities that are associated with chronic uremia. The consequences of these alterations are different from those attributed to atherosclerotic plaques and are characterized principally by hardening (stiffening) of arteries. Arteriosclerosis, characterized by stiffening of the aorta and large capacitative arteries, is a major determinant of left ventricular pressure overload and of abnormal coronary perfusion. Atherosclerosis and arteriosclerosis are frequently comorbid and characterized by a high degree of both intimal and medial calcifications in patients with ESRD. The extent of calcifications and the degree of arterial stiffening are independent predictors of mortality. Studies in patients with ESRD have shown that attenuation of arterial stiffness can have a favorable effect, associated with regression of left ventricular hypertrophy, on survival. Calciumfree, metal-free phosphate binders such as sevelamer can reduce calcification scores.

show abstract

Abdominal Aortic Calcific Deposits Are an Important Predictor of Vascular Morbidity and Mortality

Abstract: AAC deposits, detected by lateral lumbar radiograms, are a marker of subclinical atherosclerotic disease and an independent predictor of subsequent vascular morbidity and mortality.

Cited by 556 publications

References 30 publications

Coronary artery and abdominal aortic calcification are associated with cardiovascular disease in type 2 diabetes

Coronary artery and abdominal aortic calcification are associated with cardiovascular disease in type 2 diabetes

Relationships between vascular calcification, calcium metabolism, bone density, and fractures

Cardiovascular Calcifications in Uremic Patients

Contact Info

Product

Resources

About