Calcified Atherosclerosis in Different Vascular Beds and the Risk of Mortality

• Published in: Arteriosclerosis, thrombosis, and vascular biology Vol. 32; no. 1; pp. 140 - 146
• Main Authors: Allison, Matthew A, Hsi, Stephanie, Wassel, Christina L, Morgan, Cindy, Ix, Joachim H, Wright, C Michael, Criqui, Michael H
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American Heart Association, Inc 01.01.2012; Lippincott Williams & Wilkins
• Subjects: Aged; Aged, 80 and over; Aorta, Thoracic - diagnostic imaging; Atherosclerosis (general aspects, experimental research); Atherosclerosis - diagnostic imaging; Atherosclerosis - mortality; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - mortality; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - mortality; Dermatology; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Humans; Iliac Artery - diagnostic imaging; Male; Medical sciences; Middle Aged; Peripheral Arterial Disease - diagnostic imaging; Peripheral Arterial Disease - mortality; Risk Factors; Skin involvement in other diseases. Miscellaneous. General aspects; Tomography, X-Ray Computed; Vascular Calcification - diagnostic imaging; Vascular Calcification - mortality; coronary artery disease; Prognosis; Mortality; Electron beam; Cardiovascular disease; peripheral arterial disease; Coronary heart disease; Arterial disease; Vascular disease; electron beam computed tomography; outcomes; Atherosclerosis; Risk factor; Calcification; Occlusive arterial disease; Computerized axial tomography
• DOI: 10.1161/ATVBAHA.111.235234
• ISSN: 1079-5642

OBJECTIVE—The goal of this study was to determine differences in risks for total and cause-specific mortality related to calcified atherosclerosis in different vascular beds. METHODS AND RESULTS—A total of 4544 patients underwent computed tomography scans that were interrogated for calcium in different vascular beds. Mortality assessment was conducted by death certificate adjudication. At baseline, the mean age was 56.8 years, and 43% were female. After an average of 7.8 years, there were 163 deaths. With full adjustment, the presence of calcium in the thoracic aorta (hazard ratio [HR], 2.1; 95% confidence interval [CI], 1.2–3.5), carotids (HR, 1.60; CI, 1.1–2.5), and iliac (HR, 1.67; CI, 1.0–2.9) arteries were associated with total mortality, whereas the presence of coronary calcium was associated with cardiovascular disease (CVD) mortality (HR, 3.4; CI, 0.8–10.9). For severity of calcium burden, a 1-SD increment in the iliac arteries was the strongest predictor for all types of mortality. C-statistics were not significantly larger when noncoronary vascular beds were added to models with CVD risk factors or CVD risk factors plus coronary artery calcium. CONCLUSION—The associations between calcified atherosclerosis and mortality differ by vascular bed, suggesting that the location and severity of calcification in different vascular beds provide unique information for mortality.