Location, severity of calcification differs by vascular bed
MedWire News: The association between calcified atherosclerosis and mortality differs by vascular bed, researchers report.
The team found that the presence of calcium in the thoracic aorta, carotids, and iliac arteries was significantly associated with total mortality, whereas the presence of coronary calcium was significantly associated with cardiovascular disease (CVD) mortality.
Furthermore, the risk for mortality was increased with increasing increments of vascular calcium in all vascular beds.
These findings suggest that the location and severity of calcification in different vascular beds provides unique information for mortality, write Matthew Allison (University of California San Diego, USA) and co-authors in the journal Arteriosclerosis, Thrombosis, and Vascular Biology.
A total of 4544 consecutive patients who underwent computed tomography scans between November 2000 and July 2003 were included in the study.
The team reports that the prevalence of calcium in the carotid, coronary, thoracic aortic, abdominal aortic, and iliac artery was 32.2%, 55.8%, 38.2%, 54.8%, and 50.2%, respectively.
After an average of 7.8 years follow-up there were 163 deaths. In the fully adjusted model, the presence of calcium in the thoracic aorta, carotid, and iliac arteries was associated with a significant 2.07-, 1.60-, and 1.67-fold increased risk for total mortality compared with no calcium, while the presence of coronary calcium was associated with a 3.37-fold increased risk for CVD mortality.
Each standard deviation increment of calcium score was significantly associated with an increased mortality risk for all of the vascular beds, ranging from hazard ratios of 1.63 to 1.22, report Allison et al. The largest hazard was associated with the coronary arteries, they add, while the largest association for CVD mortality was found for calcium in the iliac arteries.
Commenting on the relevance of their findings, the authors explain that there are current recommendations and guidelines for the use of coronary artery calcium (CAC) in CVD risk stratification.
"Given the results of the current study, future research is warranted to determine whether current recommendations on CAC measurements should be expanded to include calcium in other vascular beds," they conclude.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
By Nikki Withers