Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Mar 30;6(4):e005093.
doi: 10.1161/JAHA.116.005093.

Aortic Calcification Onset and Progression: Association With the Development of Coronary Atherosclerosis

Hagen Kälsch  1 , Nils Lehmann  2 , Susanne Moebus  2 , Barbara Hoffmann  3 , Andreas Stang  2 , Karl-Heinz Jöckel  2 , Raimund Erbel  2 , Amir A Mahabadi  4
Affiliations

Aortic Calcification Onset and Progression: Association With the Development of Coronary Atherosclerosis

Hagen Kälsch et al. J Am Heart Assoc. .

Abstract

Background: Thoracic aortic calcification (TAC) and coronary artery calcification (CAC) are markers of subclinical atherosclerosis and are associated with incident major cardiovascular events. We investigated major determinants for incidence and progression of TAC and the association between TAC and CAC incidence and progression.

Methods and results: In a population-based cohort study, 3270 participants (aged 45-74 years, 53.1% women) received cardiac computed tomography at baseline and after a mean follow-up of 5.1±0.3 years for quantification of calcification of the ascending (ATAC) and descending thoracic aorta (DTAC) and CAC. Multivariable relative risk regression analysis was used to investigate associations of cardiovascular risk factors with incident TAC, of baseline TAC with incident CAC, and of baseline CAC with incident TAC. Of 1243 participants with baseline TAC of 0, 517 (41.6%) revealed incident TAC after 5 years. Incidence of descending TAC was higher (34.5%) than ascending TAC (23.3%). Incident TAC after 5 years was associated with age (relative risk 1.26 [95% CI 1.21-1.33], per 5 years), blood pressure (relative risk 1.06 [95% CI 1.03-1.10], per 10 mm Hg), low-density lipoprotein cholesterol (relative risk 1.08 [95% CI 1.04-1.12], per 20 mg/dL), and smoking (relative risk 1.28 [95% CI 1.07-1.53]). Among the 1185 participants without CAC at baseline, the risk of developing CAC was 28.3% when baseline TAC was present compared with 22.2% among those without baseline TAC (excess risk 6.1% [95% CI 1.2-11.0%]). The point estimate of excess risk for incident CAC was higher for ascending TAC (10.8% [95% CI 4.8-16.7%]) and low for descending TAC (1.8% [95% CI -3.2% to 6.7%]). Excess risk for developing ascending and descending TAC with present baseline CAC was 16.4% (95% CI 12.7-20.0%) and 15.6% (95% CI 10.8-20.4%), respectively.

Conclusion: TAC and CAC share similar major determinants for incident calcification. Participants with TAC, especially ascending TAC, are at elevated risk for development of CAC.

Keywords: aortic disease; calcification; cardiac CT; computed tomography; coronary artery calcification; thoracic aortic calcification.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Observed and fitted 50th, 75th, and 90th percentiles (P50, P75, and P90, respectively) of thoracic aortic calcification (TAC) distribution for (A) overall TAC, (B) ascending (asc.) TAC and (C) descending (desc.) TAC by age categories in men and women. Dark colors show baseline values when participant age was between 45 and 74 years, and light colors show 5‐year follow‐up data.
Figure 2
Figure 2
Five‐year progression of calcification with relations between vascular beds. Lengths of arrows indicate excess risk of 5‐year onset in the artery where the arrow points and contrasting presence and absence of baseline calcification where the arrow originates, IQR indicates interquartile range.
See this image and copyright information in PMC

References

    1. Kälsch H, Lehmann N, Möhlenkamp S, Hammer C, Mahabadi AA, Moebus S, Schmermund A, Stang A, Bauer M, Jöckel KH, Erbel R; Investigator Group of the Heinz Nixdorf Recall Study . Prevalence of thoracic aortic calcification and its relationship to cardiovascular risk factors and coronary calcification in an unselected population‐based cohort—the Heinz Nixdorf Recall Study. Int J Cardiovasc Imaging. 2013;29:207–216. - PubMed
    1. Schmermund A, Möhlenkamp S, Stang A, Grönemeyer D, Seibel R, Hirche H, Mann K, Siffert W, Lauterbach K, Siegrist J, Jöckel KH, Erbel R; Heinz Nixdorf Recall Study Investigative Group . Assessment of clinically silent atherosclerotic disease and established and novel risk factors for predicting myocardial infarction and cardiac death in healthy middle‐aged subjects: rationale and design of the Heinz Nixdorf Recall Study. Am Heart J. 2002;144:212–218. - PubMed
    1. Takasu J, Katz R, Nasir K, Carr JJ, Wong N, Detrano R, Budoff MJ. Relationships of thoracic aortic wall calcification to cardiovascular risk factors: the Multi‐Ethnic Study of Atherosclerosis (MESA). Am Heart J. 2008;155:765–771. - PMC - PubMed
    1. Kälsch H, Hennig F, Moebus S, Möhlenkamp S, Dragano N, Jakobs H, Memmesheimer M, Erbel R, Jöckel KH, Hoffmann B; Heinz Nixdorf Recall Study Investigative Group . Are air pollution and traffic noise independently associated with atherosclerosis: the Heinz Nixdorf Recall Study. Eur Heart J. 2014;35:853–860. - PubMed
    1. Erbel R, Möhlenkamp S, Moebus S, Schmermund A, Lehmann N, Stang A, Dragano N, Grönemeyer D, Seibel R, Kälsch H, Bröcker‐Preuss M, Mann K, Siegrist J, Jöckel KH; Heinz Nixdorf Recall Study Investigative Group . Coronary risk stratification, discrimination, and reclassification improvement based on quantification of subclinical coronary atherosclerosis: the Heinz Nixdorf Recall Study. J Am Coll Cardiol. 2010;56:1397–1406. - PubMed

LinkOut - more resources