Calcification of the splenic, iliac, and breast arteries and risk of all-cause and cardiovascular mortality

Abstract Background and aims CVD risks associated with coronary artery calcification (CAC) and aortic calcification (AC) are well known, but less is known about other calcified arteries. We aimed to assess the associations of arterial calcification in the breast, splenic, and internal and external i...

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Veröffentlicht in:Atherosclerosis 2017-04, Vol.259, p.120-127
Hauptverfasser: Hendriks, Eva. J.E, Beulens, Joline. W, de Jong, Pim. A, van der Schouw, Yvonne. T, Sun, Wei-Ning, Wright, C. Michael, Criqui, Michael. H, Allison, Matthew. A, Ix, Joachim. H
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container_end_page 127
container_issue
container_start_page 120
container_title Atherosclerosis
container_volume 259
creator Hendriks, Eva. J.E
Beulens, Joline. W
de Jong, Pim. A
van der Schouw, Yvonne. T
Sun, Wei-Ning
Wright, C. Michael
Criqui, Michael. H
Allison, Matthew. A
Ix, Joachim. H
description Abstract Background and aims CVD risks associated with coronary artery calcification (CAC) and aortic calcification (AC) are well known, but less is known about other calcified arteries. We aimed to assess the associations of arterial calcification in the breast, splenic, and internal and external iliac arteries with CVD risk factors and mortality. Methods We conducted a case-cohort study nested in a cohort of 5196 individuals who self-referred or were referred by a health care provider for whole body computed tomography (CT), including a random subcohort (n = 395) and total and CVD mortality cases (n = 298 and n = 90), who died during a median follow-up of 9.4 years. Arterial calcification in the breast, splenic, and internal and external iliac arteries on CT was scored using a simple visual score. AC and CAC were previously measured using the Agatston technique. Logistic regression models were made to study associations of CVD risk factors with calcification in the different vascular beds. Prentice-weighted Cox proportional hazards models adjusted for CVD risk factors, and calcification in other vascular beds, were used to study associations with mortality. Results In the subcohort, the mean age was 56.6 years (SD 11.1) and 41.3% were female. The prevalence of calcification on CT, was 11.6% in the splenic, 47.9% in the internal iliac and 9.5% in the external iliac arteries, while 3.7% of women had breast artery calcification (BAC). Calcification in the splenic and iliac arteries was associated with calcification in the abdominal aorta but differentially associated with other CVD risk factors in logistic regression models. The prevalence of BAC was too low to fit these multivariable models. Calcification of the external iliac arteries was significantly associated with both all-cause and CVD mortality, but no longer significant when adjusted for CVD risk factors. Breast artery calcification was associated with both all-cause and CVD mortality independent of CVD risk factors and AAC and CAC (all-cause HR 5.67 [95% CI 1.50–21.41]). Conclusions Risk factors associated with calcification, and the association of calcification with risk of mortality differ across vascular beds, possibly reflecting different pathophysiology.
doi_str_mv 10.1016/j.atherosclerosis.2017.01.029
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J.E ; Beulens, Joline. W ; de Jong, Pim. A ; van der Schouw, Yvonne. T ; Sun, Wei-Ning ; Wright, C. Michael ; Criqui, Michael. H ; Allison, Matthew. A ; Ix, Joachim. H</creator><creatorcontrib>Hendriks, Eva. J.E ; Beulens, Joline. W ; de Jong, Pim. A ; van der Schouw, Yvonne. T ; Sun, Wei-Ning ; Wright, C. Michael ; Criqui, Michael. H ; Allison, Matthew. A ; Ix, Joachim. H</creatorcontrib><description>Abstract Background and aims CVD risks associated with coronary artery calcification (CAC) and aortic calcification (AC) are well known, but less is known about other calcified arteries. We aimed to assess the associations of arterial calcification in the breast, splenic, and internal and external iliac arteries with CVD risk factors and mortality. Methods We conducted a case-cohort study nested in a cohort of 5196 individuals who self-referred or were referred by a health care provider for whole body computed tomography (CT), including a random subcohort (n = 395) and total and CVD mortality cases (n = 298 and n = 90), who died during a median follow-up of 9.4 years. Arterial calcification in the breast, splenic, and internal and external iliac arteries on CT was scored using a simple visual score. AC and CAC were previously measured using the Agatston technique. Logistic regression models were made to study associations of CVD risk factors with calcification in the different vascular beds. Prentice-weighted Cox proportional hazards models adjusted for CVD risk factors, and calcification in other vascular beds, were used to study associations with mortality. Results In the subcohort, the mean age was 56.6 years (SD 11.1) and 41.3% were female. The prevalence of calcification on CT, was 11.6% in the splenic, 47.9% in the internal iliac and 9.5% in the external iliac arteries, while 3.7% of women had breast artery calcification (BAC). Calcification in the splenic and iliac arteries was associated with calcification in the abdominal aorta but differentially associated with other CVD risk factors in logistic regression models. The prevalence of BAC was too low to fit these multivariable models. Calcification of the external iliac arteries was significantly associated with both all-cause and CVD mortality, but no longer significant when adjusted for CVD risk factors. Breast artery calcification was associated with both all-cause and CVD mortality independent of CVD risk factors and AAC and CAC (all-cause HR 5.67 [95% CI 1.50–21.41]). Conclusions Risk factors associated with calcification, and the association of calcification with risk of mortality differ across vascular beds, possibly reflecting different pathophysiology.</description><identifier>ISSN: 0021-9150</identifier><identifier>EISSN: 1879-1484</identifier><identifier>DOI: 10.1016/j.atherosclerosis.2017.01.029</identifier><identifier>PMID: 28216252</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Aged ; Breast - blood supply ; California - epidemiology ; Cardiovascular ; Cardiovascular risk factors ; Case-Control Studies ; Cause of Death ; Female ; Humans ; Iliac Artery - diagnostic imaging ; Logistic Models ; Male ; Middle Aged ; Mortality ; Multivariate Analysis ; Peripheral Arterial Disease - diagnostic imaging ; Peripheral Arterial Disease - mortality ; Predictive Value of Tests ; Prevalence ; Prognosis ; Proportional Hazards Models ; Risk Factors ; Severity of Illness Index ; Splenic Artery - diagnostic imaging ; Time Factors ; Tomography, X-Ray Computed ; Vascular calcification ; Vascular Calcification - diagnostic imaging ; Vascular Calcification - mortality ; Whole Body Imaging</subject><ispartof>Atherosclerosis, 2017-04, Vol.259, p.120-127</ispartof><rights>2017</rights><rights>Published by Elsevier B.V.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c620t-e41a4b3721f2b1da9799b22e0bc7afa1da1eaa4f81334447b43e744f62cc1e373</citedby><cites>FETCH-LOGICAL-c620t-e41a4b3721f2b1da9799b22e0bc7afa1da1eaa4f81334447b43e744f62cc1e373</cites><orcidid>0000-0002-8517-6763</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.atherosclerosis.2017.01.029$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28216252$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hendriks, Eva. J.E</creatorcontrib><creatorcontrib>Beulens, Joline. W</creatorcontrib><creatorcontrib>de Jong, Pim. A</creatorcontrib><creatorcontrib>van der Schouw, Yvonne. T</creatorcontrib><creatorcontrib>Sun, Wei-Ning</creatorcontrib><creatorcontrib>Wright, C. Michael</creatorcontrib><creatorcontrib>Criqui, Michael. H</creatorcontrib><creatorcontrib>Allison, Matthew. A</creatorcontrib><creatorcontrib>Ix, Joachim. H</creatorcontrib><title>Calcification of the splenic, iliac, and breast arteries and risk of all-cause and cardiovascular mortality</title><title>Atherosclerosis</title><addtitle>Atherosclerosis</addtitle><description>Abstract Background and aims CVD risks associated with coronary artery calcification (CAC) and aortic calcification (AC) are well known, but less is known about other calcified arteries. We aimed to assess the associations of arterial calcification in the breast, splenic, and internal and external iliac arteries with CVD risk factors and mortality. Methods We conducted a case-cohort study nested in a cohort of 5196 individuals who self-referred or were referred by a health care provider for whole body computed tomography (CT), including a random subcohort (n = 395) and total and CVD mortality cases (n = 298 and n = 90), who died during a median follow-up of 9.4 years. Arterial calcification in the breast, splenic, and internal and external iliac arteries on CT was scored using a simple visual score. AC and CAC were previously measured using the Agatston technique. Logistic regression models were made to study associations of CVD risk factors with calcification in the different vascular beds. Prentice-weighted Cox proportional hazards models adjusted for CVD risk factors, and calcification in other vascular beds, were used to study associations with mortality. Results In the subcohort, the mean age was 56.6 years (SD 11.1) and 41.3% were female. The prevalence of calcification on CT, was 11.6% in the splenic, 47.9% in the internal iliac and 9.5% in the external iliac arteries, while 3.7% of women had breast artery calcification (BAC). Calcification in the splenic and iliac arteries was associated with calcification in the abdominal aorta but differentially associated with other CVD risk factors in logistic regression models. The prevalence of BAC was too low to fit these multivariable models. Calcification of the external iliac arteries was significantly associated with both all-cause and CVD mortality, but no longer significant when adjusted for CVD risk factors. Breast artery calcification was associated with both all-cause and CVD mortality independent of CVD risk factors and AAC and CAC (all-cause HR 5.67 [95% CI 1.50–21.41]). Conclusions Risk factors associated with calcification, and the association of calcification with risk of mortality differ across vascular beds, possibly reflecting different pathophysiology.</description><subject>Aged</subject><subject>Breast - blood supply</subject><subject>California - epidemiology</subject><subject>Cardiovascular</subject><subject>Cardiovascular risk factors</subject><subject>Case-Control Studies</subject><subject>Cause of Death</subject><subject>Female</subject><subject>Humans</subject><subject>Iliac Artery - diagnostic imaging</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Peripheral Arterial Disease - diagnostic imaging</subject><subject>Peripheral Arterial Disease - mortality</subject><subject>Predictive Value of Tests</subject><subject>Prevalence</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Splenic Artery - diagnostic imaging</subject><subject>Time Factors</subject><subject>Tomography, X-Ray Computed</subject><subject>Vascular calcification</subject><subject>Vascular Calcification - diagnostic imaging</subject><subject>Vascular Calcification - mortality</subject><subject>Whole Body Imaging</subject><issn>0021-9150</issn><issn>1879-1484</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNksFu1DAQhi0EotvCK6BckDiQ4LG98eZAJbSiBakSB0DiZk2cCfWuN17sZKV9e5xuqaAnLh5pPPP_o_mGsdfAK-BQv9tUON5SDMn6-XWpEhx0xaHionnCFrDSTQlqpZ6yBecCygaW_Iydp7ThnCsNq-fsTKwE1GIpFmy7Rm9d7yyOLgxF6IusXqS9p8HZt4XzDnPAoSvaSJjGAuNI0VG6y0WXtnMPel9anBLdZS3GzoUDJjt5jMUuxBG9G48v2LMefaKX9_GCfb_6-G39qbz5cv15_eGmtLXgY0kKULVSC-hFCx02umlaIYi3VmOPOQOEqPoVSKmU0q2SpJXqa2EtkNTygl2edPdTu6PO0jBG9GYf3Q7j0QR05t-fwd2an-FgllLXS2iywJt7gRh-TZRGs3PJkvc4UJiSyTvmteJazV7vT6U2w0iR-gcb4GYGZjbmETAzAzMcTAaW-1_9PetD9x9CueD6VEB5YwdH0STraLDUuUh2NF1w_211-UjJepcpo9_SkdImTHHIWAyYJAw3X-frmY8HtORcwg_5G7qcyMs</recordid><startdate>20170401</startdate><enddate>20170401</enddate><creator>Hendriks, Eva. J.E</creator><creator>Beulens, Joline. W</creator><creator>de Jong, Pim. A</creator><creator>van der Schouw, Yvonne. T</creator><creator>Sun, Wei-Ning</creator><creator>Wright, C. Michael</creator><creator>Criqui, Michael. H</creator><creator>Allison, Matthew. A</creator><creator>Ix, Joachim. H</creator><general>Elsevier B.V</general><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>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-8517-6763</orcidid></search><sort><creationdate>20170401</creationdate><title>Calcification of the splenic, iliac, and breast arteries and risk of all-cause and cardiovascular mortality</title><author>Hendriks, Eva. J.E ; Beulens, Joline. W ; de Jong, Pim. A ; van der Schouw, Yvonne. T ; Sun, Wei-Ning ; Wright, C. Michael ; Criqui, Michael. H ; Allison, Matthew. A ; Ix, Joachim. H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c620t-e41a4b3721f2b1da9799b22e0bc7afa1da1eaa4f81334447b43e744f62cc1e373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Breast - blood supply</topic><topic>California - epidemiology</topic><topic>Cardiovascular</topic><topic>Cardiovascular risk factors</topic><topic>Case-Control Studies</topic><topic>Cause of Death</topic><topic>Female</topic><topic>Humans</topic><topic>Iliac Artery - diagnostic imaging</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Peripheral Arterial Disease - diagnostic imaging</topic><topic>Peripheral Arterial Disease - mortality</topic><topic>Predictive Value of Tests</topic><topic>Prevalence</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Splenic Artery - diagnostic imaging</topic><topic>Time Factors</topic><topic>Tomography, X-Ray Computed</topic><topic>Vascular calcification</topic><topic>Vascular Calcification - diagnostic imaging</topic><topic>Vascular Calcification - mortality</topic><topic>Whole Body Imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hendriks, Eva. J.E</creatorcontrib><creatorcontrib>Beulens, Joline. W</creatorcontrib><creatorcontrib>de Jong, Pim. A</creatorcontrib><creatorcontrib>van der Schouw, Yvonne. T</creatorcontrib><creatorcontrib>Sun, Wei-Ning</creatorcontrib><creatorcontrib>Wright, C. Michael</creatorcontrib><creatorcontrib>Criqui, Michael. H</creatorcontrib><creatorcontrib>Allison, Matthew. A</creatorcontrib><creatorcontrib>Ix, Joachim. H</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Atherosclerosis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hendriks, Eva. J.E</au><au>Beulens, Joline. W</au><au>de Jong, Pim. A</au><au>van der Schouw, Yvonne. T</au><au>Sun, Wei-Ning</au><au>Wright, C. Michael</au><au>Criqui, Michael. H</au><au>Allison, Matthew. A</au><au>Ix, Joachim. H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Calcification of the splenic, iliac, and breast arteries and risk of all-cause and cardiovascular mortality</atitle><jtitle>Atherosclerosis</jtitle><addtitle>Atherosclerosis</addtitle><date>2017-04-01</date><risdate>2017</risdate><volume>259</volume><spage>120</spage><epage>127</epage><pages>120-127</pages><issn>0021-9150</issn><eissn>1879-1484</eissn><abstract>Abstract Background and aims CVD risks associated with coronary artery calcification (CAC) and aortic calcification (AC) are well known, but less is known about other calcified arteries. We aimed to assess the associations of arterial calcification in the breast, splenic, and internal and external iliac arteries with CVD risk factors and mortality. Methods We conducted a case-cohort study nested in a cohort of 5196 individuals who self-referred or were referred by a health care provider for whole body computed tomography (CT), including a random subcohort (n = 395) and total and CVD mortality cases (n = 298 and n = 90), who died during a median follow-up of 9.4 years. Arterial calcification in the breast, splenic, and internal and external iliac arteries on CT was scored using a simple visual score. AC and CAC were previously measured using the Agatston technique. Logistic regression models were made to study associations of CVD risk factors with calcification in the different vascular beds. Prentice-weighted Cox proportional hazards models adjusted for CVD risk factors, and calcification in other vascular beds, were used to study associations with mortality. Results In the subcohort, the mean age was 56.6 years (SD 11.1) and 41.3% were female. The prevalence of calcification on CT, was 11.6% in the splenic, 47.9% in the internal iliac and 9.5% in the external iliac arteries, while 3.7% of women had breast artery calcification (BAC). Calcification in the splenic and iliac arteries was associated with calcification in the abdominal aorta but differentially associated with other CVD risk factors in logistic regression models. The prevalence of BAC was too low to fit these multivariable models. Calcification of the external iliac arteries was significantly associated with both all-cause and CVD mortality, but no longer significant when adjusted for CVD risk factors. Breast artery calcification was associated with both all-cause and CVD mortality independent of CVD risk factors and AAC and CAC (all-cause HR 5.67 [95% CI 1.50–21.41]). Conclusions Risk factors associated with calcification, and the association of calcification with risk of mortality differ across vascular beds, possibly reflecting different pathophysiology.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>28216252</pmid><doi>10.1016/j.atherosclerosis.2017.01.029</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-8517-6763</orcidid><oa>free_for_read</oa></addata></record>
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source MEDLINE; Access via ScienceDirect (Elsevier)
subjects Aged
Breast - blood supply
California - epidemiology
Cardiovascular
Cardiovascular risk factors
Case-Control Studies
Cause of Death
Female
Humans
Iliac Artery - diagnostic imaging
Logistic Models
Male
Middle Aged
Mortality
Multivariate Analysis
Peripheral Arterial Disease - diagnostic imaging
Peripheral Arterial Disease - mortality
Predictive Value of Tests
Prevalence
Prognosis
Proportional Hazards Models
Risk Factors
Severity of Illness Index
Splenic Artery - diagnostic imaging
Time Factors
Tomography, X-Ray Computed
Vascular calcification
Vascular Calcification - diagnostic imaging
Vascular Calcification - mortality
Whole Body Imaging
title Calcification of the splenic, iliac, and breast arteries and risk of all-cause and cardiovascular mortality
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