Aortic valve sclerosis is a marker of atherosclerosis independently of traditional clinical risk factors. Analysis in 712 patients without ischemic heart disease

Rossi, Andrea; Faggiano, Pompilio; Amado, Alexandra E.; Cicoira, Mariantonietta; Bonapace, Stefano; Franceschini, Lorenzo; Lloyd, F.; Ghio, Stefano; Agricola, Eustachio; Temporelli, Pier Luigi; Vassanelli, C.

doi:10.1016/j.ijcard.2012.04.101

Cited by 7 publications

(7 citation statements)

References 15 publications

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“…Additionally, AVS and CAD shared the same histopathological characteristics of atherosclerosis. furthermore, previous studies documented a strong direct association between AVS and atherosclerosis in different arterial districts [13] . Some hypothesis states that AVS could be an indicator of subclinical CAD.…”

Section: Discussionmentioning

confidence: 76%

Association between Aortic Sclerosis and Coronary Artery Disease

Elsayyed

Montaser²,

Ahmed³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: Although there is a recognized link between cardiovascular hazards and coronary artery disease (CAD), it is still unknown whether aortic sclerosis and CAD are linked.Objective: This study aimed to check whether if there is a link between aortic sclerosis and the existence and severity of coronary artery disease . Patients and methods: 204 individuals were enrolled in the study, transthoracic echocardiographic, and coronary angiography were done. Aortic leaflets were tested for the amount of thickness in the short axis view. The involvement of coronary arteries represented by the gensini score and the association between aortic valve sclerosis score and the degree and severity of coronary affection was investigated using the Gensini score. Results: The individuals were divided into 2 groups grounded on the severity of aortic valve sclerosis. Group A (GP A) included patients with aortic valve sclerosis (AVS) ≥ 2 and group B (GP B) included patients with AVS < 2. In GP A, the right coronary cusp was the most afflicted one, whereas the LAD was the most affected in coronaries. The degree and severity of CAD were more significant in GP A, as evidenced by a higher Gensini score value of 39.27 versus 28.84 in GP B. Conclusion: AVS has been found to be correlated with the presence and severity of CAD and could be used as a potential surrogate marker for the illness.

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Section: Discussionmentioning

confidence: 76%

Association between Aortic Sclerosis and Coronary Artery Disease

Elsayyed

Montaser²,

Ahmed³

et al. 2022

The Egyptian Journal of Hospital Medicine

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“…Carotid atherosclerosis is defined as carotid intima-media thickness (CIMT) ≥1.0 mm or the presence of carotid plaque ( 36 ). A previous study reported an association between the presence of carotid atherosclerosis and degenerative aortic stenosis ( 37 ); the risk of carotid atherosclerosis was 2.1 times higher in patients with aortic valve sclerosis than in control patients ( 38 ). In the current study, the risk of carotid atherosclerosis was 10 times higher in patients with aortic valve stenosis.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a new prediction model for calcific aortic valve stenosis

Chen¹,

Zhu²,

Xiong³

et al. 2022

J Thorac Dis

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Background: Calcific aortic valve stenosis (CAVS) is a common valvular heart disease, but there are limited reports on the construction of prediction models for CAVS. This study aimed to investigate the risk factors for CAVS and construct a predictive model for CAVS based on its common clinical features.Methods: Patients with CAVS who underwent surgical treatment in our hospital from 2016 to 2020 and those who underwent physical examination during the same period were retrospectively studied and placed in the CAVS group and normal group based on the area of aortic valve orifice less than or more than 3 cm 2 . A total of 548 patients were included in this study, including 106 CAVS patients and 442 normal patients. Subjects were randomly divided into training and validation sets at a 7:3 ratio. The features were dimensionally reduced using the Least Absolute Shrinkage and Selection Operator (LASSO) algorithm in the training set, and the optimal clinical features were selected. The independent predictors of patients with CAVS were determined by univariate and multivariate logistic regression, and nomogram was constructed.The calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) were used to evaluate the model in both the training set and the validation set. Results: In this study, 11 independent predictors were distinguished by multivariate logistic regression analysis: history of hypertension, history of carotid atherosclerosis, age, diastolic blood pressure, C-reactive protein, direct bilirubin, alkaline phosphatase, low-density lipoprotein (LDL), lipoprotein(a) [Lp(a)], uric acid, and cystatin C. A nomogram was constructed using the above indicators. The model was well-calibrated and showed good discrimination and accuracy [the area under the curve (AUC) =0.981] in the training set, with a sensitivity of 91.89% and a specificity of 95.48%. More importantly, the nomogram displayed a good performance in the validation set (AUC =0.955, 95% CI: 0.925-0.985), with a sensitivity of 93.75% and a specificity of 84.09%. Additionally, DCA revealed that the nomogram had high clinical practicability. Conclusions: This study successfully established a risk prediction model for CAVS based on 11 conveniently accessible clinical indicators, which might easily be used for individualized risk assessment of CAVS.

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“…5,6 Besides, the development of AVSc involves chronic inflammatory reactions characterized by endothelial damage, deposition of lipoproteins, infiltration of inflammatory cells, and oxidative stress, which directly results in extracellular matrix degradation and calcification, akin to atherosclerosis as well. 7 Additionally, AVSc predicts all-cause and cardiovascular mortality. 8 Tissue plasminogen activator (t-PA), a glycoprotein produced by vascular endothelial cells, induces clot dissolution by converting plasminogen to plasmin, 9 and acts as an in vivo marker of endothelial cell injury.…”

Section: Introductionmentioning

confidence: 99%

Prognostic role of tissue plasminogen activator in coronary artery disease with or without aortic valve sclerosis

et al. 2023

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Aims We sought to investigate the relationship between circulating tissue plasminogen activator (t‐PA) level and long‐term outcomes in stable coronary artery disease patients with or without aortic valve sclerosis (AVSc). Methods and results Serum levels of t‐PA were determined in 347 consecutive stable angina patients with (n = 183) or without (n = 164) AVSc. Outcomes were prospectively recorded as planned clinic evaluations every 6 months up to 7 years. The primary endpoint was a composite of cardiovascular death and rehospitalization due to heart failure. The secondary endpoint included all‐cause mortality, cardiovascular death, and rehospitalization due to heart failure. Serum t‐PA was significantly higher in AVSc than in non‐AVSc patients (2131.22 pg/mL vs. 1495.85 pg/mL, P < 0.001). For patients with AVSc, those with t‐PA level above the median (>1840.68 pg/mL) were more likely to meet the primary and secondary endpoints (all P < 0.001). After adjusting for potential confounding factors, serum t‐PA level remained significantly predictive for each endpoint in the Cox proportional hazard models. The prognostic value of t‐PA was good, with an AUC‐ROC of 0.753 (P < 0.001). The combination of t‐PA with traditional risk factors improved the risk reclassification of AVSc patients, with a net reclassification index of 0.857 and an integrated discrimination improvement of 0.217 (all P < 0.001). However, for patients without AVSc, both primary and secondary endpoints were similar, irrespective of t‐PA levels. Conclusions Elevated circulating t‐PA confers an increased risk for poor long‐term clinical outcomes in stable coronary artery disease patients with AVSc.

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Aortic valve sclerosis is a marker of atherosclerosis independently of traditional clinical risk factors. Analysis in 712 patients without ischemic heart disease

Cited by 7 publications

References 15 publications

Association between Aortic Sclerosis and Coronary Artery Disease

Association between Aortic Sclerosis and Coronary Artery Disease

Development and validation of a new prediction model for calcific aortic valve stenosis

Prognostic role of tissue plasminogen activator in coronary artery disease with or without aortic valve sclerosis

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