Association of thoracic aortic calcium with incident cardiovascular disease and all-cause mortality across the spectrum of coronary artery calcium burden

被引:0
作者
Razavi, Alexander C. [1 ,2 ,3 ]
Dzaye, Omar [3 ]
Cainzos-Achirica, Miguel [4 ]
Dardari, Zeina [3 ]
Van Assen, Marly [2 ]
Quyyumi, Arshed A. [1 ]
Nasir, Khurram [4 ]
Carr, J. Jeffrey [5 ]
Budoff, Matthew J. [6 ]
Blumenthal, Roger S. [3 ]
Raggi, Paolo [7 ]
De Cecco, Carlo N. [2 ]
Sperling, Laurence S. [1 ]
Blaha, Michael J. [3 ]
Whelton, Seamus P. [3 ]
机构
[1] Emory Univ, Ctr Heart Dis Prevent, Sch Med, Atlanta, GA USA
[2] Emory Univ, Dept Radiol & Imaging Sci, Translat Lab Cardiothorac Imaging & Artificial Int, Sch Med, Atlanta, GA USA
[3] Johns Hopkins Univ, Johns Hopkins Ciccarone Ctr Prevent Cardiovasc Dis, Sch Med, Baltimore, MD 21218 USA
[4] Houston Methodist DeBakey Heart & Vasc Ctr, Div Cardiovasc Prevent & Wellness, Houston, TX USA
[5] Vanderbilt Univ, Dept Radiol & Radiol Sci, Sch Med, Nashville, TN USA
[6] Lundquist Inst, Harbor UCLAR Med Ctr, Torrance, CA USA
[7] Univ Alberta, Dept Med, Div Cardiol, Edmonton, AB, Canada
来源
AMERICAN JOURNAL OF PREVENTIVE CARDIOLOGY | 2025年 / 21卷
关键词
Thoracic aorta; Thoracic aortic calcium; Vascular calcification; Computed tomography; Atherosclerosis; Coronary artery calcium; Cardiovascular disease; ATHEROSCLEROSIS; CALCIFICATION; EVENTS; PREDICTION; REPRODUCIBILITY; HYPERTENSION; TOMOGRAPHY; POPULATION; GLUCOSE; PLASMA;
D O I
10.1016/j.ajpc.2024.100916
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Calcification of the ascending and/or descending thoracic aorta is easily measured via non-contrast cardiac computed tomography (CT), commonly performed for quantification of coronary artery calcium (CAC). of Cardiology (2025) We assessed whether thoracic aortic calcium (TAC) further improves long-term cardiovascular disease (CVD) risk stratification beyond CAC alone. Methods: Cardiac CT was performed among 6,783 asymptomatic Multi-Ethnic Study of Atherosclerosis participants at baseline. Cox proportional hazards regression assessed the association of TAC with incident CVD and all- cause mortality over a median follow-up of 17.7 years, adjusting for CVD risk factors and CAC. Results: The mean age was 62.1 years old, 53% were female, and 28% had TAC. Over a median follow-up of 17.7 years, 48% of participants with TAC >= 500 experienced CVD and 72% died. Compared to TAC=0, TAC >= 500 was significantly associated with an increased risk of CVD (HR=1.28, 95% CI: 1.06-1.54) and all-cause mortality (HR=1.44, 95% CI: 1.25-1.65), with the strongest association among persons with CAC=0 (CVD HR=1.79, 95% CI: 1.04-3.07; all-cause mortality HR=1.82, 95% CI: 1.29-2.56). The addition of TAC to traditional risk factors and CAC did not improve CVD discrimination (Delta C-statistic=+0.002, p=0.12), but incrementally improved prediction of all-cause mortality (CVD: Delta C-statistic=+0.002, p=0.02). Conclusions: Participants with TAC >= 500 had a high long-term risk for CVD and all-cause mortality. TAC primarily improved risk stratification among persons with CAC=0.
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页数:9
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