Objective-Complex atherosclerotic lesions contain radio-opaque calcium hydroxyapatite deposits with the degree of calcification correlating with the extent of atherosclerosis. In this study, we aim to determine the patterns of systemic atherosclerotic calcification. Methods and Results-Whole-body electron beam computed tomography scans were performed on 650 asymptomatic subjects to assess the carotid, coronary, proximal, and distal aorta and iliac vessels for atherosclerotic calcification. The mean age was 57.3 and 53% were male. Correlation patterns were similar in both genders, with the largest interbed correlations between the distal aorta and iliac vessels (rϭ0.51 to 0.60). The average man and woman had calcium earliest in the coronaries (younger than age 50 years) and the distal aorta (age 50 to 60), respectively. The prevalence of calcium was greater than 80% for most beds in men older than age 70 and greater than 60% in all beds for women. Approximately on third of subjects younger than 50 were free of calcified disease, whereas all subjects older than 70 were found to have some calcium. Age and hypertension were the dominant risk factors for systemic calcified atherosclerosis. A therosclerosis begins in childhood and progresses from fatty streaks to raised lesions in adolescence and young adulthood. 1-3 Raised lesions further progress to mature atheroma and complex lesions later in adulthood. Complex lesions and many atheroma contain radio-opaque calcium hydroxyapatite deposits, 4,5 and the degree of calcification in arteries appears to correlate highly with the extent of atherosclerosis. 6 Calcified plaques have been detected throughout the vasculature using computed tomography. 7 Electron beam computed tomography is a noninvasive, reproducible 8 screening procedure used to detect coronary calcification. Coronary calcification has been shown to be directly related to the severity and extent of underlying coronary plaque burden. 9 Histopathologic research has also shown a high correlation between the extent of coronary calcification and total coronary atherosclerotic plaque burden. 10 These correlations (rϭ0.90) have been shown to be true for all ages and for both sexes. 11 The purpose of this study was to determine the correlations and patterns of calcified atherosclerosis in 5 different vascular beds as well as the relationship of atherosclerosis in these beds with traditional cardiovascular risk factors. Conclusions-This Methods SubjectsFrom February 2001 to May 2002, 650 consecutive asymptomatic subjects who presented for preventive medicine services at a university-affiliated disease prevention center in San Diego, California were evaluated for the extent of calcified atherosclerosis in 5 different vascular beds: carotid, coronary, proximal aorta, distal aorta, and iliac vessels. Most subjects were self-referred or referred by their primary care provider.All subjects completed a detailed health history questionnaire before undergoing the scanning procedure. Smoking status was defined as current, for...

Background-Atherosclerosis has been implicated as a cause of valvular calcification. The aim of this study was to determine whether atherosclerotic calcification in multiple vascular areas is significantly associated with aortic or mitral annular calcification independent of traditional risk factors. Methods and Results-A total of 1242 consecutive asymptomatic patients free of clinical coronary heart disease were studied by electron-beam computed tomography for the extent of calcium due to atherosclerosis in 5 distinct vascular beds and calcium in the aortic and mitral annuli. Nearly 24% had calcium in the aortic annulus, whereas 8% were found to have mitral annular calcification. Age and a history of hypertension were the only traditional cardiovascular risk factors that were independently associated with prevalent calcification in the aortic and mitral annuli. After adjustment for age, gender, and cardiovascular disease risk factors, subjects with calcium in the thoracic aorta had the highest odds for the presence of aortic annular calcium (ORϭ3.9, PϽ0.01), whereas those with calcium in the abdominal aorta had the highest odds for mitral annular calcification (ORϭ5.1, Pϭ0.01). Standardized increases in calcium in the abdominal aorta (ORϭ2.0, PϽ0.01) and iliacs (ORϭ1.8, Pϭ0.01) were significantly associated with calcium in the aortic annulus after adjustment for the extent of calcium in the other vascular beds, whereas the thoracic aorta was significantly associated (ORϭ1.4, Pϭ0.02) with calcium in the mitral annulus. Conclusions-This

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...