(Circulation. 2001;103:1529.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
Abdominal Aortic Calcific Deposits Are an Important Predictor of Vascular Morbidity and Mortality
From the From the NHLBI’s Framingham Heart Study and Boston University School of Medicine, Framingham, Mass (P.W.F.W., L.I.K., C.J.O.); the Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston (C.J.O.); Hebrew Rehabilitation Center for the Aged, Harvard Medical School, Division on Aging, Boston (D.P.K., M.H.); Brigham and Women’s Hospital, Harvard Medical School, Boston (J.M.P.); and the Department of Biostatistics and Epidemiology, Boston University School of Public Health, Boston, Mass (L.A.C.). Dr Kauppila is currently located in Espoo, Finland.
Correspondence to Dr Wilson, Framingham Heart Study, Boston University School of Medicine, 5 Thurber Street, Framingham, MA 01702. E-mail pwilson{at}bumc.bu.edu
Background—The impact of abdominal arterial calcific deposits on the prediction of cardiovascular disease (CVD) over a long follow-up interval deserves greater scrutiny.
Methods and Results—Lateral lumbar radiographs were studied as a predictor of incident coronary heart disease (CHD), CVD, and CVD mortality in 1049 men and 1466 women (mean age, 61 years) who were followed from 1967 to 1989. Anterior and posterior wall calcific deposits in the aorta at the level of the first through fourth lumbar vertebrae were graded according to increasing severity using a previously validated rating scale for abdominal aortic calcium (AAC) that ranges from 0 to 24 points. There were 454 cases of CHD, 709 cases of CVD, and 365 CVD deaths. Proportional hazards logistic regression was used to test for associations between AAC and later events after adjustment for age, cigarette use, diabetes mellitus, systolic blood pressure, left ventricular hypertrophy, body mass index, cholesterol, and HDL cholesterol. In comparisons with the lowest AAC tertile, the multivariate age-adjusted relative risks (RR) for CVD were increased in tertile 2 (men: RR, 1.33; 95% confidence interval [CI], 1.02 to 1.74; women: RR, 1.25; 95% CI, 0.95 to 1.65) and tertile 3 (men: RR, 1.68; 95% CI, 1.25 to 2.27; women: RR, 1.78; 95% CI, 1.33 to 2.38). Similar results were obtained with CHD and CVD mortality.
Conclusions—AAC deposits, detected by lateral lumbar radiograms, are a marker of subclinical atherosclerotic disease and an independent predictor of subsequent vascular morbidity and mortality.
Key Words: coronary disease • calcium • risk factors
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