Aortic calcification is associated with coronary artery calcification and is a potential surrogate marker for ischemic heart disease risk: A cross-sectional study

Abstract

Coronary artery calcification, an established marker of atherosclerotic plaque burden associated with increased risk of coronary artery disease, is routinely evaluated using electron beam computerized tomography or multidetector computed tomography (CT). However, aortic calcification, which is also a risk factor for adverse cardiac events, is not frequently assessed, despite being easily detected via standard chest radiography. We therefore sought to clarify the association between aortic calcification and significant coronary artery calcification to determine the feasibility of performing chest radiography to evaluate the risk of future cardiovascular events. Data from 682 consecutive patients who underwent cardiac CT scanning at our institution from May to September 2012 were included in this cross-sectional analysis. Electrocardiographic-gated CT was used to qualitatively evaluate calcification in 6 aortic segments. Cardiac contrast-ehnanced CT was performed to identify significant calcification of the coronary artery. Calcification was quantified by calculating the Agatston score, and the relationship between significant coronary artery calcification and calcification at each aortic site was evaluated. Among the aortic sites, calcification was most commonly observed in the aortic arch (77.4% of patients). Significant coronary artery calcification was observed in 267 patients (39.1%). Calcification in the ascending aorta, aortic arch, descending aorta, abdominal aorta, and aortic valve were significantly associated with the presence of coronary artery calcification after adjustment for cardiovascular risk factors and statin use (odds ratios [95% confidence intervals] 4.21 [2.55, 6.93], 1.65 [1.01, 2.69], 2.14 [1.36, 3.36], 2.87 [1.83, 4.50], and 3.32 [2.02, 5.46], respectively). Mitral valve calcification was weakly but nonsignificantly associated with coronary artery calcification (odds ratio 1.84 [95% confidence interval 0.94, 3.62]). Calcification of each aortic segment assessed was significantly associated with Agatston score ≥ 100. Aortic calcification was associated with coronary artery calcification. Calcification of the aortic arch, which can be readily detected by routine chest radiography, may be associated with coronary artery calcification and its assessment should therefore be considered to identify patients at increased risk of cardiovascular events. Further studies are warranted to confirm these findings.

Percutaneous transluminal coronary angioplasty in a 52‐year‐old patient with porcelain aorta and calcified coronaries: A case report

“…Recent studies have shown that aortic calcification is associated with coronary calcification 10 . The same finding was evident in our patient, as shown in Figures 2–4.…”

Aortic Diameters and Calcifications in Former World-Class Cyclists

“…Indeed, most cyclists had no aortic calcifications, and when present, the extension of this condition was low, with no impairment in aortic distensibility compared with nonathletes. Moreover, although aortic calcifications (including those in the ascending portion) have been previously associated with coronary calcifications (32), in the present cohort, former cyclists had similar CAC scores to controls, as reported in a previous study (17). In this regard, some evidence suggests that aortic calcifications are positively associated with cardiovascular risk, but this association disappears when adjusting for coronary calcifications (14).…”

Coronary atherosclerotic plaque regression strategies

“…There are not much data about the effect of alcohol on plaque progression either. A cross-sectional study showed that the levels of macrophage infiltration and lipid core volume among subjects who underwent femoral endarterectomy as well as coronary calcification measured by CT, were both inversely associated with alcohol consumption [40] . However, no studies providing visualization of coronary plaque volumes or longitudinal studies have been conducted [41] .…”