Background The prognostic importance of abdominal aortic calcification (AAC) viewed on noninvasive imaging modalities remains uncertain. Methods and Results We searched electronic databases (MEDLINE and Embase) until March 2018. Multiple reviewers identified prospective studies reporting AAC and incident cardiovascular events or all‐cause mortality. Two independent reviewers assessed eligibility and risk of bias and extracted data. Summary risk ratios (RRs) were estimated using random‐effects models comparing the higher AAC groups combined (any or more advanced AAC) to the lowest reported AAC group. We identified 52 studies (46 cohorts, 36 092 participants); only studies of patients with chronic kidney disease (57%) and the general older‐elderly (median, 68 years; range, 60–80 years) populations (26%) had sufficient data to meta‐analyze. People with any or more advanced AAC had higher risk of cardiovascular events (RR, 1.83; 95% CI, 1.40–2.39), fatal cardiovascular events (RR, 1.85; 95% CI, 1.44–2.39), and all‐cause mortality (RR, 1.98; 95% CI, 1.55–2.53). Patients with chronic kidney disease with any or more advanced AAC had a higher risk of cardiovascular events (RR, 3.47; 95% CI, 2.21–5.45), fatal cardiovascular events (RR, 3.68; 95% CI, 2.32–5.84), and all‐cause mortality (RR, 2.40; 95% CI, 1.95–2.97). Conclusions Higher‐risk populations, such as the elderly and those with chronic kidney disease with AAC have substantially greater risk of future cardiovascular events and poorer prognosis. Providing information on AAC may help clinicians understand and manage patients' cardiovascular risk better.

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S371 mobility status on long-term outcomes in elderly patients with NSTEMI is unknown. Methods: A retrospective analysis included 956 consecutive patients aged >85 years presenting with NSTEMI between 2010-2018. Mobility status was classified as independent, single point stick (SPS), 4-wheel frame (4WF) or wheelchair dependent. Guideline-directed medical therapy (GDMT) included aspirin, beta-blockers and statins. The primary outcome was all-cause mortality. Results: Of 956 patients, 304 (33.7%) had independent mobility, 161 (17.9%) used a SPS and 402 (44.6%) used a 4WF. GDMT adherence did not vary significantly between the SPS and independent groups. However, adherence to GMDT was significantly lower in 4WF users (p < 0.001). Independent patients had higher rates of coronary angiography (19.5% vs 10% SPS vs 2% 4WF, p < 0.001) and had improved long-term survival (HR 0.68, 0.55-0.84, p < 0.001). SPS users did not experience reduced long-term survival (p = 0.3, whereas 4WF users had significantly greater long-term mortality (HR 1.5, 1.2-1.9, p < 0.001). This risk remained significant, albeit reduced (HR 1.3 1.1-1.7, p = 0.02) after Cox-proportional hazard modelling. Conclusion: There is an association between mobility status and prescription of GDMT and coronary angiography in elderly patients. Using a 4WF, but not a SPS, was associated with higher mortality.