Aortic arch calcification predicts the extent of coronary atherosclerosis in patients with or without type 2 diabetes: short communication

Effectiveness of SCORE2 and ASCVD Risk Scores in Combination With Aortic Arch Calcification on Chest Radiograph in Predicting Significant Coronary Artery Disease

The present study evaluated 10-year atherosclerotic cardiovascular disease (ASCVD) risk using ASCVD and Systematic Coronary Risk Evaluation (SCORE2) risk models in combination with aortic arch calcification (AAC) to identify those at high risk for significant coronary artery disease (CAD) in patients undergoing coronary angiography. Of the 402 patients enrolled, 48 had normal coronary angiograms and served as group 1. The 131 patients with CAD with stenosis of <70% as group 2 and 223 patients with CAD with stenosis of ≥70% as group 3. ASCVD and SCORE2 risk scores, and the presence of AAC differed significantly among these groups. For prediction of significant CAD, the area under the curve (AUC) of ASCVD and SCORE2 risk scores in receiver operating characteristic (ROC) curve analysis were statistically similar ([AUC: .647, P < .001] and [AUC: .654, P < .001], respectively). When AAC was added to ASCVD risk and SCORE2, it increased their predictive value for significant CAD in the ROC curve analysis (P = .003, and P = .019, respectively). In addition, significant net reclassification improvement (NRI) values were obtained by adding AAC to ASCVD and SCORE2 risk models ([NRI = .10, P = .04], and [NRI = .19, P = .04], respectively). These results suggest that the predictive value of ASCVD and SCORE2 increases when AAC is combined.

Differences Between Coronary Artery Calcification and Aortic Artery Calcification in Relation to Cardiovascular Disease Risk Factors in Japanese Men

AIMS

Calcification in the coronary and aortic arteries has been linked to cardiovascular morbidity and mortality. The pathophysiological influence of aortic artery calcification (AAC) differs from that of coronary artery calcification (CAC). We aimed to compare the relationships between CAC and AAC and cardiovascular disease (CVD) risk factors.

METHODS

We examined a random sample of 1035 Japanese men aged 40-79 years. CAC and AAC were measured by computed tomography and scored according to the Agatston method. Using a logistic regression, we calculated the odds ratio (OR) as being in the highest quintile (Q5) of the calcification score compared to the lower quintiles (Q1-Q4) per 1 standard deviation higher CVD risk factor. Models were simultaneously adjusted for age, body mass index (BMI), systolic blood pressure, smoking (pack-year), alcohol intake, hemoglobin A1c, uric acid, estimated glomerular filtration rate (eGFR), serum lipids, and C-reactive protein. Differences in ORs were investigated using a generalized estimating equation. We performed a multiple linear regression using log-transformed CAC and AAC values as dependent variables.

RESULTS

CAC and AAC were independently associated with age (OR, 95% CI: 2.30 [1.77-2.98] for CAC and 3.48 [2.57-4.73] for AAC), p for difference ＜0.001), systolic blood pressure (1.29 [1.08-1.53] and 1.28 [1.07-1.54], p for difference=0.270), and smoking (1.22, [1.04-1.43] and 1.34 [1.13-1.58]) p for difference=0.071). Alcohol correlated with AAC only (1.17 [0.97-1.41] for CAC and 1.42 [1.16-1.73] for AAC, p for difference= 0.020).

CONCLUSIONS

CAC and AAC were associated with similar CVD risk factors. The strength of association slightly differed between CAC and AAC.

Association of alcohol consumption and aortic calcification in healthy men aged 40-49 years for the ERA JUMP Study

BACKGROUND AND AIMS

Several studies have reported a significant inverse association of light to moderate alcohol consumption with coronary heart disease (CHD). However, studies assessing the relationship between alcohol consumption and atherosclerosis have reported inconsistent results. The current study was conducted to determine the relationship between alcohol consumption and aortic calcification.

METHODS

We addressed the research question using data from the population-based ERA-JUMP Study, comprising of 1006 healthy men aged 40-49 years, without clinical cardiovascular diseases, from four race/ethnicities: 301 Whites, 103 African American, 292 Japanese American, and 310 Japanese in Japan. Aortic calcification was assessed by electron-beam computed tomography and quantified using the Agatston method. Alcohol consumption was categorized into four groups: 0 (non-drinkers), ≤1 (light drinkers), >1 to ≤3 (moderate drinkers) and >3 drinks per day (heavy drinkers) (1 drink = 12.5 g of ethanol). Tobit conditional regression and ordinal logistic regression were used to investigate the association of alcohol consumption with aortic calcification after adjusting for cardiovascular risk factors and potential confounders.

RESULTS

The study participants consisted of 25.6% nondrinkers, 35.3% light drinkers, 23.5% moderate drinkers, and 15.6% heavy drinkers. Heavy drinkers [Tobit ratio (95% CI) = 2.34 (1.10, 4.97); odds ratio (95% CI) = 1.67 (1.11, 2.52)] had significantly higher expected aortic calcification score compared to nondrinkers, after adjusting for socio-demographic and confounding variables. There was no significant interaction between alcohol consumption and race/ethnicity on aortic calcification.

CONCLUSIONS

Our findings suggest that heavy alcohol consumption may be an independent risk factor for atherosclerosis.

Not at random location of atherosclerotic lesions in thoracic aorta and their prognostic significance in relation to the risk of cardiovascular events

Thoracic aortic calcium deposits are frequently detected on tomography of the chest, and in other imaging modalities. Numerous studies indicated the correlation of hemodynamic parameters such as wall shear stress in relation to distribution aortic calcifications. This publication discusses similarities and differences of two distinct pathomechanisms of arterial calcifications: intimal associated with atherosclerosis and medial knows as Mönckeberg’s arteriosclerosis. This review also analyzes the frequent coexistence of aortic calcification and coronary artery disease in terms of risk of cardiovascular events.

Alcohol consumption and aortic arch calcification in an older Chinese sample: the Guangzhou Biobank Cohort Study

OBJECTIVE

To examine the association between alcohol consumption and aortic arch calcification (AAC) in an older Chinese sample.

METHODS

In 27,844 older people aged 50-85, socioeconomic position and lifestyle factors were assessed by a questionnaire. The presence and severity of AAC were diagnosed from chest X-ray by two experienced radiologists.

RESULTS

In men, the risk for AAC increased significantly in frequent or excessive drinkers [adjusted odds ratio (OR)=1.36 (95% confidence interval (CI) 1.16-1.59) and 1.49 (1.21-1.83) for those who drank >5 times/week and those who drank excessively, respectively] (P for trend from 0.002 to 0.001). When AAC was analyzed as an outcome variable with 3 categories of severity, significant dose-response relations between the severity of AAC and alcohol consumption were observed, with those who drank frequently (>5/week) or excessively having more serious AAC (P for trend=0.03 and 0.02, respectively). No significant association was found in women as few drank excessively.

CONCLUSION

The presence and severity of AAC were associated with quantity or frequency of alcohol consumption in a dose-response pattern, suggesting that alcohol drinking, even when moderate, has no benefit for AAC. Excessive drinking increased the risk of AAC by 50% compared to never drinkers.

Passive smoking and aortic arch calcification in older Chinese never smokers: the Guangzhou Biobank Cohort Study

OBJECTIVE

To study whether passive smoking is a risk factor for aortic arch calcification (AAC) among never smokers.

BACKGROUND

We have previously reported that active smoking increases the risk of AAC, but the effect of passive smoking has not been reported.

METHODS

We used baseline data of the Phase 1 Guangzhou Biobank Cohort Study (GBCS). 7702 older Chinese never smokers from the Phase 1 GBCS were included. Information on passive smoking and potential confounders were collected by standardized interviews and laboratory assays. AAC was diagnosed from chest X-ray by two experienced radiologists. Unconditional logistic regression was used to estimate odds ratios of AAC for passive smoking with adjustment for potential confounders.

RESULTS

In women, the risk for aortic arch calcification (AAC) increased significantly with increasing duration of adulthood passive smoking exposure at home, at work and total duration of adulthood home and work exposure [adjusted odds ratio 1.24 (95% confidence interval 1.09-1.41) for high level of total exposure] (P for trend from 0.012 to 0.001). For passive smoking at home, at work and total exposure, significant trends of increasing severity of AAC with increasing duration of exposure were observed in men and women combined (P for trend from 0.05 to 0.002).

CONCLUSION

Passive smoking is a risk factor for aortic arch calcification. Studies of passive smoking and AAC, especially in developing countries can generate important local evidence to raise awareness and to support public health measures to protect non-smokers from second-hand smoke.