Association of thoracic aortic calcium with incident cardiovascular disease and all-cause mortality across the spectrum of coronary artery calcium burden
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). We assessed whether thoracic aortic calcium (TAC) further improves long-term cardi...
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| Language: | English |
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Elsevier
2025-03-01
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| Series: | American Journal of Preventive Cardiology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S266666772400285X |
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| author | Alexander C. Razavi Omar Dzaye Miguel Cainzos-Achirica Zeina Dardari Marly Van Assen Arshed A. Quyyumi Khurram Nasir J. Jeffrey Carr Matthew J. Budoff Roger S. Blumenthal Paolo Raggi Carlo N. De Cecco Laurence S. Sperling Michael J. Blaha Seamus P. Whelton |
| author_facet | Alexander C. Razavi Omar Dzaye Miguel Cainzos-Achirica Zeina Dardari Marly Van Assen Arshed A. Quyyumi Khurram Nasir J. Jeffrey Carr Matthew J. Budoff Roger S. Blumenthal Paolo Raggi Carlo N. De Cecco Laurence S. Sperling Michael J. Blaha Seamus P. Whelton |
| author_sort | Alexander C. Razavi |
| collection | DOAJ |
| description | 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). 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 (ΔC-statistic=+0.002, p=0.12), but incrementally improved prediction of all-cause mortality (CVD: ΔC-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. |
| format | Article |
| id | doaj-art-6559752b4d18496d9d815a64357a99c3 |
| institution | Kabale University |
| issn | 2666-6677 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Preventive Cardiology |
| spelling | doaj-art-6559752b4d18496d9d815a64357a99c32025-01-15T04:11:57ZengElsevierAmerican Journal of Preventive Cardiology2666-66772025-03-0121100916Association of thoracic aortic calcium with incident cardiovascular disease and all-cause mortality across the spectrum of coronary artery calcium burdenAlexander C. Razavi0Omar Dzaye1Miguel Cainzos-Achirica2Zeina Dardari3Marly Van Assen4Arshed A. Quyyumi5Khurram Nasir6J. Jeffrey Carr7Matthew J. Budoff8Roger S. Blumenthal9Paolo Raggi10Carlo N. De Cecco11Laurence S. Sperling12Michael J. Blaha13Seamus P. Whelton14Center for Heart Disease Prevention, Emory University School of Medicine, Atlanta, GA, United States; Translational Laboratory for Cardiothoracic Imaging and Artificial Intelligence, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States; Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United StatesJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United StatesDivision of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, United StatesJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United StatesTranslational Laboratory for Cardiothoracic Imaging and Artificial Intelligence, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United StatesCenter for Heart Disease Prevention, Emory University School of Medicine, Atlanta, GA, United StatesDivision of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, United StatesDepartment of Radiology and Radiological Sciences, Vanderbilt University School of Medicine, Nashville, TN, United StatesLundquist Institute, Harbor-UCLAR Medical Center, Torrance, CA, United StatesJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United StatesDepartment of Medicine and Division of Cardiology, University of Alberta, Edmonton, Alberta, CanadaTranslational Laboratory for Cardiothoracic Imaging and Artificial Intelligence, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United StatesCenter for Heart Disease Prevention, Emory University School of Medicine, Atlanta, GA, United StatesJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United StatesJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Corresponding author.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). 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 (ΔC-statistic=+0.002, p=0.12), but incrementally improved prediction of all-cause mortality (CVD: ΔC-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.http://www.sciencedirect.com/science/article/pii/S266666772400285XThoracic aortaThoracic aortic calciumVascular calcificationComputed tomographyAtherosclerosisCoronary artery calcium |
| spellingShingle | Alexander C. Razavi Omar Dzaye Miguel Cainzos-Achirica Zeina Dardari Marly Van Assen Arshed A. Quyyumi Khurram Nasir J. Jeffrey Carr Matthew J. Budoff Roger S. Blumenthal Paolo Raggi Carlo N. De Cecco Laurence S. Sperling Michael J. Blaha Seamus P. Whelton Association of thoracic aortic calcium with incident cardiovascular disease and all-cause mortality across the spectrum of coronary artery calcium burden American Journal of Preventive Cardiology Thoracic aorta Thoracic aortic calcium Vascular calcification Computed tomography Atherosclerosis Coronary artery calcium |
| title | Association of thoracic aortic calcium with incident cardiovascular disease and all-cause mortality across the spectrum of coronary artery calcium burden |
| title_full | Association of thoracic aortic calcium with incident cardiovascular disease and all-cause mortality across the spectrum of coronary artery calcium burden |
| title_fullStr | Association of thoracic aortic calcium with incident cardiovascular disease and all-cause mortality across the spectrum of coronary artery calcium burden |
| title_full_unstemmed | Association of thoracic aortic calcium with incident cardiovascular disease and all-cause mortality across the spectrum of coronary artery calcium burden |
| title_short | Association of thoracic aortic calcium with incident cardiovascular disease and all-cause mortality across the spectrum of coronary artery calcium burden |
| title_sort | association of thoracic aortic calcium with incident cardiovascular disease and all cause mortality across the spectrum of coronary artery calcium burden |
| topic | Thoracic aorta Thoracic aortic calcium Vascular calcification Computed tomography Atherosclerosis Coronary artery calcium |
| url | http://www.sciencedirect.com/science/article/pii/S266666772400285X |
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