Is Mitral Annular Calcification Associated With Atherosclerotic Risk Factors and Severity and Complexity of Coronary Artery Disease?

Abstract

We assessed the association of mitral annular calcification (MAC) with atherosclerotic risk factors and severity and complexity of coronary artery disease (CAD). Cardiac catheterization reports and electronic medical records from 2010 to 2011 were retrospectively reviewed. A total of 481 patients were divided into 2 groups: MAC present (209) and MAC absent (272). All major cardiovascular risk factors, comorbidities, and coronary lesion characteristics were included. On linear regression analysis, age (P = .001, β 1.12) and female gender (P = .031, β 0.50) were the independent predictors of MAC. Mitral annular calcification was not independently associated with the presence of lesions with >70% stenosis (P = .283), number of obstructive vessels (P = .469), lesions with 50% to 70% stenosis (P = .458), and Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery score (P = .479). Mitral annular calcification is probably a benign marker of age-related degenerative changes in the heart independent of the severity and complexity of CAD.

Association between coronary tortuosity and mitral annular calcification

“…MAC has been consistently linked with age and is considered a marker of senile degenerative changes in the heart. 24,26,[27][28][29] The present study was the first to evaluate the relationship between CorT and MAC. In our study, there was a significant association between MAC and CorT.…”

“…Female gender has been associated with the presence of MAC. 20,25 Bhatt et al 26 reported that female gender was an independent predictor of MAC. MAC has been consistently linked with age and is considered a marker of senile degenerative changes in the heart.…”

Degenerative Mitral Stenosis

“…16,33,34 Chronic kidney disease has also been demonstrated to predispose to the development of MAC. 35 This may be related to the disturbed calcium-phosphorus homeostasis with excess calcium being deposited in the annular tissue.…”

Mitral Annular Calcification and Cardiovascular Diseases

“…11 The main limitations of this study are the lack of data on aortic valve calcification (AVC) and severity of MAC. 11 In a subgroup analysis of the Framingham Heart Study, risks of incident cardiovascular disease, cardiovascular death, and all-cause death was found to increase by approximately 10% per 1-mm increase in MAC thickness. 12 In the Northern Manhattan Study, the increased cardiovascular event risk was directly related to MAC severity rather than its presence.…”

“…3 In another study, not trivial but advanced MAC was significantly associated with CAD. 13 In their retrospective study, Bhatt et al 11 mentioned that AVC should be looked at separately from MAC. However, it has been previously shown that in patients with mild to moderate aortic stenosis, there is more extensive MAC and AVC in patients with tricuspid aortic valves compared with bicuspid aortic valves independent of age and systemic blood pressure.…”