Multifocal cardiovascular calcification in patients with established cardiovascular disease; prevalence, risk factors, and relation with recurrent cardiovascular disease
Aims: The aim is to investigate (multifocal) cardiovascular calcification in patients with established cardiovascular disease (CVD), regarding prevalence, risk factors, and relation with recurrent CVD or vascular interventions. Coronary artery calcification (CAC), thoracic aortic calcification (TAC)...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-04-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906720300683 |
| _version_ | 1828973419726635008 |
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| author | Cilie C. van 't Klooster Hendrik M. Nathoe J. Hjortnaes Michiel L. Bots Ivana Isgum Nikolas Lessmann Yolanda van der Graaf Tim Leiner Frank L.J. Visseren |
| author_facet | Cilie C. van 't Klooster Hendrik M. Nathoe J. Hjortnaes Michiel L. Bots Ivana Isgum Nikolas Lessmann Yolanda van der Graaf Tim Leiner Frank L.J. Visseren |
| author_sort | Cilie C. van 't Klooster |
| collection | DOAJ |
| description | Aims: The aim is to investigate (multifocal) cardiovascular calcification in patients with established cardiovascular disease (CVD), regarding prevalence, risk factors, and relation with recurrent CVD or vascular interventions. Coronary artery calcification (CAC), thoracic aortic calcification (TAC) (including ascending aorta, aortic arch, descending aorta), mitral annular calcification (MAC), and aortic valve calcification (AVC) are studied. Methods: The study concerned 568 patients with established CVD enrolled in the ORACLE cohort. All patients underwent computed tomography. Prevalence of site-specific and multifocal calcification was determined. Ordinal regression analyses were performed to quantify associations of risk factors with cardiovascular calcification, and Cox regression analyses to determine the relation between calcium scores and recurrent CVD or vascular interventions. Results: Calcification was multifocal in 76% (N = 380) of patients with calcification. Age (per SD) was associated with calcification at all locations (lowest OR 2.17; 99%CI 1.54–3.11 for ascending aorta calcification). Diabetes mellitus and systolic blood pressure were associated with TAC, whereas male sex was a determinant of CAC. TAC and CAC were related to the combined endpoint CVD or vascular intervention (N = 68). In a model with all calcium scores combined, only CAC was related to the combined outcome (HR 1.39; 95%CI 1.15–1.68). Conclusion: Cardiovascular calcification is generally multifocal in patients with established CVD. Differences in associations between risk factors and calcification at various anatomical locations stress the divergence in pathophysiological pathways. CAC is most strongly related to recurrent CVD or vascular interventions independent of traditional risk factors, and independent of heart valve and thoracic aorta calcification. Keywords: Patients with established cardiovascular disease, Multifocal cardiovascular calcification, Prevalence, Risk factors, Recurrent cardiovascular disease |
| first_indexed | 2024-12-14T13:45:56Z |
| format | Article |
| id | doaj.art-2ae8fbcbb05d496f81d89de318e5cf38 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-12-14T13:45:56Z |
| publishDate | 2020-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-2ae8fbcbb05d496f81d89de318e5cf382022-12-21T22:59:19ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672020-04-0127Multifocal cardiovascular calcification in patients with established cardiovascular disease; prevalence, risk factors, and relation with recurrent cardiovascular diseaseCilie C. van 't Klooster0Hendrik M. Nathoe1J. Hjortnaes2Michiel L. Bots3Ivana Isgum4Nikolas Lessmann5Yolanda van der Graaf6Tim Leiner7Frank L.J. Visseren8Department of Vascular Medicine, University Medical Center Utrecht (UMCU), Utrecht University, the NetherlandsDepartment of Cardiology, University Medical Center Utrecht (UMCU), Utrecht University, the NetherlandsDepartment of Cardiothoracic Surgery, University Medical Center Utrecht (UMCU), Utrecht University, the Netherlands; Regenerative Medicine Center Utrecht, University Medical Center Utrecht (UMCU), Utrecht University, the NetherlandsJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht University, the NetherlandsImage Sciences Institute, University Medical Center Utrecht (UMCU), Utrecht University, the NetherlandsImage Sciences Institute, University Medical Center Utrecht (UMCU), Utrecht University, the NetherlandsJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht University, the NetherlandsDepartment of Radiology, University Medical Center Utrecht (UMCU), Utrecht University, the NetherlandsDepartment of Vascular Medicine, University Medical Center Utrecht (UMCU), Utrecht University, the Netherlands; Corresponding author at: Department of Vascular Medicine, University Medical Centre Utrecht, PO Box 85500, 3508 GA Utrecht, the Netherlands.Aims: The aim is to investigate (multifocal) cardiovascular calcification in patients with established cardiovascular disease (CVD), regarding prevalence, risk factors, and relation with recurrent CVD or vascular interventions. Coronary artery calcification (CAC), thoracic aortic calcification (TAC) (including ascending aorta, aortic arch, descending aorta), mitral annular calcification (MAC), and aortic valve calcification (AVC) are studied. Methods: The study concerned 568 patients with established CVD enrolled in the ORACLE cohort. All patients underwent computed tomography. Prevalence of site-specific and multifocal calcification was determined. Ordinal regression analyses were performed to quantify associations of risk factors with cardiovascular calcification, and Cox regression analyses to determine the relation between calcium scores and recurrent CVD or vascular interventions. Results: Calcification was multifocal in 76% (N = 380) of patients with calcification. Age (per SD) was associated with calcification at all locations (lowest OR 2.17; 99%CI 1.54–3.11 for ascending aorta calcification). Diabetes mellitus and systolic blood pressure were associated with TAC, whereas male sex was a determinant of CAC. TAC and CAC were related to the combined endpoint CVD or vascular intervention (N = 68). In a model with all calcium scores combined, only CAC was related to the combined outcome (HR 1.39; 95%CI 1.15–1.68). Conclusion: Cardiovascular calcification is generally multifocal in patients with established CVD. Differences in associations between risk factors and calcification at various anatomical locations stress the divergence in pathophysiological pathways. CAC is most strongly related to recurrent CVD or vascular interventions independent of traditional risk factors, and independent of heart valve and thoracic aorta calcification. Keywords: Patients with established cardiovascular disease, Multifocal cardiovascular calcification, Prevalence, Risk factors, Recurrent cardiovascular diseasehttp://www.sciencedirect.com/science/article/pii/S2352906720300683 |
| spellingShingle | Cilie C. van 't Klooster Hendrik M. Nathoe J. Hjortnaes Michiel L. Bots Ivana Isgum Nikolas Lessmann Yolanda van der Graaf Tim Leiner Frank L.J. Visseren Multifocal cardiovascular calcification in patients with established cardiovascular disease; prevalence, risk factors, and relation with recurrent cardiovascular disease International Journal of Cardiology: Heart & Vasculature |
| title | Multifocal cardiovascular calcification in patients with established cardiovascular disease; prevalence, risk factors, and relation with recurrent cardiovascular disease |
| title_full | Multifocal cardiovascular calcification in patients with established cardiovascular disease; prevalence, risk factors, and relation with recurrent cardiovascular disease |
| title_fullStr | Multifocal cardiovascular calcification in patients with established cardiovascular disease; prevalence, risk factors, and relation with recurrent cardiovascular disease |
| title_full_unstemmed | Multifocal cardiovascular calcification in patients with established cardiovascular disease; prevalence, risk factors, and relation with recurrent cardiovascular disease |
| title_short | Multifocal cardiovascular calcification in patients with established cardiovascular disease; prevalence, risk factors, and relation with recurrent cardiovascular disease |
| title_sort | multifocal cardiovascular calcification in patients with established cardiovascular disease prevalence risk factors and relation with recurrent cardiovascular disease |
| url | http://www.sciencedirect.com/science/article/pii/S2352906720300683 |
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