Coronary artery calcium (CAC) is a powerful predictor of cardiovascular disease (CVD). Furthermore, thoracic extra-coronary calcification (ECC) (e.g., aortic valve calcification) has offered predictive information in addition to CAC. However, data on CAC and ECC as predictors of CVD outcomes in adults aged 75 years are scarce. The near-term prognosis was rarely reported, despite its relevance in the 75-and-older population given life expectancy.
For a study, researchers used modified Cox models to examine the associations of CAC and ECC with CVD (including CHD, stroke, and heart failure) in 1,672 ARIC individuals (age 75-94 years) without a history of clinical coronary heart disease (CHD) at visit 7 (2018-2019). CAC and ECC were modeled in two ways: categorically (Agatston scores 0-99 [reference], 100-299, and 300+), and continuously (log[Agatston score+1].
Higher CAC and calcium scores in the aortic valve (only when modeled continuously) and ascending aorta were substantially linked to an increased risk of CVD (e.g., adjusted hazard ratio [HR]: 2.79 [95% CI 1.21, 6.44] for CAC 300+ vs. 0-99.). After removing people with a history of stroke, they found that the relationship between aortic valve calcium 300+ and CVD was statistically significant (HR 2.31 [95% CI 1.02, 5.24]). In addition, significant correlations between CHD and heart failure were seen in CAC (only when modeled continuously) and ascending aorta calcium (e.g., 4.98 [95% CI 1.10, 22.58] for CHD and 6.88 [2.14, 22.04] in ascending aorta calcium 300+) when each CVD event was examined independently. Calcifications of the coronary artery, ascending aorta, and aortic valve were all linked to a higher 1-year risk of CVD in those aged 75 and over. The findings corroborated the predictive usefulness of CAC and ECC in elderly persons and implied that various vascular beds have varied prognostic consequences.