Risk Factors for the Development and Progression of Thoracic Aorta Calcification

Abstract

Background Vascular calcification independently predicts cardiovascular disease (CVD) and computed tomography (CT) is a useful tool to evaluate and quantify not only coronary but also thoracic aortic calcification (TAC). Previous TAC progression reports were limited to dialysis and renal transplant patients. This is the first study to evaluate TAC progression in a large multi-ethnic cohort without clinically evident CVD at entry. Methods Non-contrast enhanced cardiac CT were obtained in 5886 of 6814 MESA participants (mean age 62 years; 48% males; 40% white, 27% Black, 21% Hispanic, 12% Chinese. Baseline and follow-up TAC scores were derived. Results 4308(73%) participants had no detectable baseline TAC. Mean follow-up duration was 2.4±0.8 years, during which 12% developed TAC. The overall incidence rate was 4.8%/year and was greater with age across gender and ethnic groups; TAC incidence was significantly lower in blacks than whites. After adjustment for follow-up duration, regression analyses showed age, systolic blood pressure, antihypertensives, and smoking were associated with incident TAC. 1578(27%) participants had TAC at baseline with a positive association between average annual TAC change and baseline age. While the overall median change was 32.9 (−1.4, 112.2) Agatston units, 27% showed an annual score change of ≥100 and blacks showed the lowest median across ethnic groups; 22.7 (−3, 86.8). Age, systolic BP, lipid-lowering medication, diabetes and smoking were associated with TAC progression. Conclusion In MESA, traditional CV risk factors were related to both TAC incidence and progression. Blacks had the lowest incidence and median change across ethnic groups, consistent with previous findings for coronary calcification.

Aortic Calcification Onset and Progression: Association With the Development of Coronary Atherosclerosis

“…Taking the strong association of thoracic aortic with coronary calcification into account, the identification of main determinants for TAC incidence and progression may play a pivotal role in cardiovascular prevention. In a multiethnic population‐based cohort, Youssef et al found age, systolic blood pressure, intake of antihypertensive medication, and smoking to be associated with TAC i , thus not discriminating between the ascending and descending thoracic aorta . Accordingly, our results reveal—aside from age and sex—systolic blood pressure and LDL‐C as the main determinants of TAC i , especially in the ascending aorta.…”

Hyperphosphatemia and hs-CRP Initiate the Coronary Artery Calcification in Peritoneal Dialysis Patients

“…Results from the Multi-Ethnic Study of Atherosclerosis (MESA) also showed the age, SBP, smoking, LDL, HDL, and creatinine were related to the incident CAC risk [18, 19]. In our study, the SBP in noninitiation group were controlled better than that in initiation group, which reveal the role of blood pressure in initiating the CAC in PD patients.…”

Increased Aortic Calcification Is Associated With Arterial Stiffness Progression in Multiethnic Middle-Aged Men

“…Calcification within the aorta has been established as a risk factor for cardiovascular morbidity and mortality 11,12 . Also multiple conventional risk factors, including age, blood pressure and smoking, are associated with aortic calcification 13 . We 14 and others 15–19 have reported a significant positive association between aortic calcification and arterial stiffness in cross-sectional data of healthy population 14,16,19 , as well as in patients with isolated systolic hypertension 17 , peripheral arterial disease 20 and chronic kidney disease 21 .…”