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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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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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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