Relation of Aortic Valve Calcium Detected by Cardiac Computed Tomography to All-Cause Mortality
Aortic valve calcium (AVC) can be quantified on the same computed tomographic scan as coronary artery calcium (CAC). Although CAC is an established predictor of cardiovascular events, limited evidence is available for an independent predictive value for AVC. We studied a cohort of 8,401 asymptomatic...
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creator | Blaha, Michael J., MD, MPH Budoff, Matthew J., MD Rivera, Juan J., MD, MPH Khan, Atif N., MD Santos, Raul D., MD, PhD Shaw, Leslee J., PhD Raggi, Paolo, MD Berman, Daniel, MD Rumberger, John A., MD, PhD Blumenthal, Roger S., MD Nasir, Khurram, MD, MPH |
description | Aortic valve calcium (AVC) can be quantified on the same computed tomographic scan as coronary artery calcium (CAC). Although CAC is an established predictor of cardiovascular events, limited evidence is available for an independent predictive value for AVC. We studied a cohort of 8,401 asymptomatic subjects (mean age 53 ± 10 years, 69% men), who were free of known coronary heart disease and were undergoing electron beam computed tomography for assessment of subclinical atherosclerosis. The patients were followed for a median of 5 years (range 1 to 7) for the occurrence of mortality from any cause. Multivariate Cox regression models were developed to predict all-cause mortality according to the presence of AVC. A total of 517 patients (6%) had AVC on electron beam computed tomography. During follow-up, 124 patients died (1.5%), for an overall survival rate of 96.1% and 98.7% for those with and without AVC, respectively (hazard ratio 3.39, 95% confidence interval 2.09 to 5.49). After adjustment for age, gender, hypertension, dyslipidemia, diabetes mellitus, smoking, and a family history of premature coronary heart disease, AVC remained a significant predictor of mortality (hazard ratio 1.82, 95% confidence interval 1.11 to 2.98). Likelihood ratio chi-square statistics demonstrated that the addition of AVC contributed significantly to the prediction of mortality in a model adjusted for traditional risk factors (chi-square = 5.03, p = 0.03) as well as traditional risk factors plus the presence of CAC (chi-square = 3.58, p = 0.05). In conclusion, AVC was associated with increased all-cause mortality, independent of the traditional risk factors and the presence of CAC. |
doi_str_mv | 10.1016/j.amjcard.2010.08.019 |
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Although CAC is an established predictor of cardiovascular events, limited evidence is available for an independent predictive value for AVC. We studied a cohort of 8,401 asymptomatic subjects (mean age 53 ± 10 years, 69% men), who were free of known coronary heart disease and were undergoing electron beam computed tomography for assessment of subclinical atherosclerosis. The patients were followed for a median of 5 years (range 1 to 7) for the occurrence of mortality from any cause. Multivariate Cox regression models were developed to predict all-cause mortality according to the presence of AVC. A total of 517 patients (6%) had AVC on electron beam computed tomography. During follow-up, 124 patients died (1.5%), for an overall survival rate of 96.1% and 98.7% for those with and without AVC, respectively (hazard ratio 3.39, 95% confidence interval 2.09 to 5.49). After adjustment for age, gender, hypertension, dyslipidemia, diabetes mellitus, smoking, and a family history of premature coronary heart disease, AVC remained a significant predictor of mortality (hazard ratio 1.82, 95% confidence interval 1.11 to 2.98). Likelihood ratio chi-square statistics demonstrated that the addition of AVC contributed significantly to the prediction of mortality in a model adjusted for traditional risk factors (chi-square = 5.03, p = 0.03) as well as traditional risk factors plus the presence of CAC (chi-square = 3.58, p = 0.05). In conclusion, AVC was associated with increased all-cause mortality, independent of the traditional risk factors and the presence of CAC.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2010.08.019</identifier><identifier>PMID: 21055710</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aortic Valve - diagnostic imaging ; Biological and medical sciences ; Calcinosis - diagnostic imaging ; Calcinosis - mortality ; Calcium ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; Cause of Death ; Female ; Follow-Up Studies ; Heart Valve Diseases - diagnostic imaging ; Heart Valve Diseases - mortality ; Humans ; Male ; Medical sciences ; Middle Aged ; Mortality ; Multivariate analysis ; Ohio - epidemiology ; Prognosis ; Reproducibility of Results ; Retrospective Studies ; Risk Factors ; Survival Rate ; Tomography ; Tomography, X-Ray Computed - methods</subject><ispartof>The American journal of cardiology, 2010-12, Vol.106 (12), p.1787-1791</ispartof><rights>2010</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2010. Published by Elsevier Inc.</rights><rights>Copyright Elsevier Sequoia S.A. 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Although CAC is an established predictor of cardiovascular events, limited evidence is available for an independent predictive value for AVC. We studied a cohort of 8,401 asymptomatic subjects (mean age 53 ± 10 years, 69% men), who were free of known coronary heart disease and were undergoing electron beam computed tomography for assessment of subclinical atherosclerosis. The patients were followed for a median of 5 years (range 1 to 7) for the occurrence of mortality from any cause. Multivariate Cox regression models were developed to predict all-cause mortality according to the presence of AVC. A total of 517 patients (6%) had AVC on electron beam computed tomography. During follow-up, 124 patients died (1.5%), for an overall survival rate of 96.1% and 98.7% for those with and without AVC, respectively (hazard ratio 3.39, 95% confidence interval 2.09 to 5.49). After adjustment for age, gender, hypertension, dyslipidemia, diabetes mellitus, smoking, and a family history of premature coronary heart disease, AVC remained a significant predictor of mortality (hazard ratio 1.82, 95% confidence interval 1.11 to 2.98). Likelihood ratio chi-square statistics demonstrated that the addition of AVC contributed significantly to the prediction of mortality in a model adjusted for traditional risk factors (chi-square = 5.03, p = 0.03) as well as traditional risk factors plus the presence of CAC (chi-square = 3.58, p = 0.05). In conclusion, AVC was associated with increased all-cause mortality, independent of the traditional risk factors and the presence of CAC.</description><subject>Aortic Valve - diagnostic imaging</subject><subject>Biological and medical sciences</subject><subject>Calcinosis - diagnostic imaging</subject><subject>Calcinosis - mortality</subject><subject>Calcium</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Cause of Death</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Valve Diseases - diagnostic imaging</subject><subject>Heart Valve Diseases - mortality</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Ohio - epidemiology</subject><subject>Prognosis</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Survival Rate</subject><subject>Tomography</subject><subject>Tomography, X-Ray Computed - methods</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkl-L1DAUxYMo7uzqR1CCID51TNKmaV5chrr-gRVBV1_DnSTV1LQZk3ah396UGVfYF59CLr97cu_JQegZJVtKaP2638LQa4hmy0iukWZLqHyANrQRsqCSlg_RhhDCCkkreYbOU-rzlVJeP0ZnjBLOBSUbpL5YD5MLIw4d3oU4OY2_g7-1uAWv3Tzgt3ayerIG75dci8aBxm0YDvNauwlD-BHh8HPBU8A774sW5mTxp6wE3k3LE_SoA5_s09N5gb69u7ppPxTXn99_bHfXheYVm4qua0xdMei0rKEGoJqyrmJcGmYI5bo0kuoKBNSMVYITwploKi74HnTHy7K8QK-OuocYfs82TWpwSVvvYbRhTqqhXNYVaXgmX9wj-zDHMQ-XISmyrhAZ4kdIx5BStJ06RDdAXBQlavVf9erkv1r9V6RR2f_c9_wkPu8Ha-66_hqegZcnAJIG30UYtUv_uFKQsmRV5i6PnM2m3TobVdLOjtoaF_N3KBPcf0d5c09Beze6_Ogvu9h0tzRViSmivq5hWbNCc0pqJmT5B3bIuQ8</recordid><startdate>20101215</startdate><enddate>20101215</enddate><creator>Blaha, Michael J., MD, MPH</creator><creator>Budoff, Matthew J., MD</creator><creator>Rivera, Juan J., MD, MPH</creator><creator>Khan, Atif N., MD</creator><creator>Santos, Raul D., MD, PhD</creator><creator>Shaw, Leslee J., PhD</creator><creator>Raggi, Paolo, MD</creator><creator>Berman, Daniel, MD</creator><creator>Rumberger, John A., MD, PhD</creator><creator>Blumenthal, Roger S., MD</creator><creator>Nasir, Khurram, MD, MPH</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20101215</creationdate><title>Relation of Aortic Valve Calcium Detected by Cardiac Computed Tomography to All-Cause Mortality</title><author>Blaha, Michael J., MD, MPH ; Budoff, Matthew J., MD ; Rivera, Juan J., MD, MPH ; Khan, Atif N., MD ; Santos, Raul D., MD, PhD ; Shaw, Leslee J., PhD ; Raggi, Paolo, MD ; Berman, Daniel, MD ; Rumberger, John A., MD, PhD ; Blumenthal, Roger S., MD ; Nasir, Khurram, MD, MPH</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c542t-ff8d642afc96a6aa1c12f4259d2d015c3d91c4a7a6224750052784575bacf5333</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Aortic Valve - diagnostic imaging</topic><topic>Biological and medical sciences</topic><topic>Calcinosis - diagnostic imaging</topic><topic>Calcinosis - mortality</topic><topic>Calcium</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Cause of Death</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Valve Diseases - diagnostic imaging</topic><topic>Heart Valve Diseases - mortality</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Ohio - epidemiology</topic><topic>Prognosis</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Survival Rate</topic><topic>Tomography</topic><topic>Tomography, X-Ray Computed - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Blaha, Michael J., MD, MPH</creatorcontrib><creatorcontrib>Budoff, Matthew J., MD</creatorcontrib><creatorcontrib>Rivera, Juan J., MD, MPH</creatorcontrib><creatorcontrib>Khan, Atif N., MD</creatorcontrib><creatorcontrib>Santos, Raul D., MD, PhD</creatorcontrib><creatorcontrib>Shaw, Leslee J., PhD</creatorcontrib><creatorcontrib>Raggi, Paolo, MD</creatorcontrib><creatorcontrib>Berman, Daniel, MD</creatorcontrib><creatorcontrib>Rumberger, John A., MD, PhD</creatorcontrib><creatorcontrib>Blumenthal, Roger S., MD</creatorcontrib><creatorcontrib>Nasir, Khurram, MD, MPH</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Blaha, Michael J., MD, MPH</au><au>Budoff, Matthew J., MD</au><au>Rivera, Juan J., MD, MPH</au><au>Khan, Atif N., MD</au><au>Santos, Raul D., MD, PhD</au><au>Shaw, Leslee J., PhD</au><au>Raggi, Paolo, MD</au><au>Berman, Daniel, MD</au><au>Rumberger, John A., MD, PhD</au><au>Blumenthal, Roger S., MD</au><au>Nasir, Khurram, MD, MPH</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relation of Aortic Valve Calcium Detected by Cardiac Computed Tomography to All-Cause Mortality</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2010-12-15</date><risdate>2010</risdate><volume>106</volume><issue>12</issue><spage>1787</spage><epage>1791</epage><pages>1787-1791</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Aortic valve calcium (AVC) can be quantified on the same computed tomographic scan as coronary artery calcium (CAC). Although CAC is an established predictor of cardiovascular events, limited evidence is available for an independent predictive value for AVC. We studied a cohort of 8,401 asymptomatic subjects (mean age 53 ± 10 years, 69% men), who were free of known coronary heart disease and were undergoing electron beam computed tomography for assessment of subclinical atherosclerosis. The patients were followed for a median of 5 years (range 1 to 7) for the occurrence of mortality from any cause. Multivariate Cox regression models were developed to predict all-cause mortality according to the presence of AVC. A total of 517 patients (6%) had AVC on electron beam computed tomography. During follow-up, 124 patients died (1.5%), for an overall survival rate of 96.1% and 98.7% for those with and without AVC, respectively (hazard ratio 3.39, 95% confidence interval 2.09 to 5.49). After adjustment for age, gender, hypertension, dyslipidemia, diabetes mellitus, smoking, and a family history of premature coronary heart disease, AVC remained a significant predictor of mortality (hazard ratio 1.82, 95% confidence interval 1.11 to 2.98). Likelihood ratio chi-square statistics demonstrated that the addition of AVC contributed significantly to the prediction of mortality in a model adjusted for traditional risk factors (chi-square = 5.03, p = 0.03) as well as traditional risk factors plus the presence of CAC (chi-square = 3.58, p = 0.05). In conclusion, AVC was associated with increased all-cause mortality, independent of the traditional risk factors and the presence of CAC.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>21055710</pmid><doi>10.1016/j.amjcard.2010.08.019</doi><tpages>5</tpages></addata></record> |
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subjects | Aortic Valve - diagnostic imaging Biological and medical sciences Calcinosis - diagnostic imaging Calcinosis - mortality Calcium Cardiology Cardiology. Vascular system Cardiovascular Cardiovascular disease Cause of Death Female Follow-Up Studies Heart Valve Diseases - diagnostic imaging Heart Valve Diseases - mortality Humans Male Medical sciences Middle Aged Mortality Multivariate analysis Ohio - epidemiology Prognosis Reproducibility of Results Retrospective Studies Risk Factors Survival Rate Tomography Tomography, X-Ray Computed - methods |
title | Relation of Aortic Valve Calcium Detected by Cardiac Computed Tomography to All-Cause Mortality |
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