Prevalence of Aortic Valve Calcium and the Long-Term Risk of Incident Severe Aortic Stenosis

Seamus P. Whelton, Kunal Jha, Zeina Dardari, Alexander C. Razavi, Ellen Boakye, Omar Dzaye, Dhiran Verghese, Sanjiv Shah, Matthew J. Budoff, Kunihiro Matsushita, J. Jeffery Carr, Ramachandran S. Vasan, Roger S. Blumenthal, Khalil Anchouche, George Thanassoulis, Xiuqing Guo, Jerome I. Rotter, Robyn L. McClelland, Wendy S. Post, Michael J. Blaha

Producción científica: Articlerevisión exhaustiva

7 Citas (Scopus)


Background: Aortic valve calcification (AVC) is a principal mechanism underlying aortic stenosis (AS). Objectives: This study sought to determine the prevalence of AVC and its association with the long-term risk for severe AS. Methods: Noncontrast cardiac computed tomography was performed among 6,814 participants free of known cardiovascular disease at MESA (Multi-Ethnic Study of Atherosclerosis) visit 1. AVC was quantified using the Agatston method, and normative age-, sex-, and race/ethnicity-specific AVC percentiles were derived. The adjudication of severe AS was performed via chart review of all hospital visits and supplemented with visit 6 echocardiographic data. The association between AVC and long-term incident severe AS was evaluated using multivariable Cox HRs. Results: AVC was present in 913 participants (13.4%). The probability of AVC >0 and AVC scores increased with age and were generally highest among men and White participants. In general, the probability of AVC >0 among women was equivalent to men of the same race/ethnicity who were approximately 10 years younger. Incident adjudicated severe AS occurred in 84 participants over a median follow-up of 16.7 years. Higher AVC scores were exponentially associated with the absolute risk and relative risk of severe AS with adjusted HRs of 12.9 (95% CI: 5.6-29.7), 76.4 (95% CI: 34.3-170.2), and 380.9 (95% CI: 169.7-855.0) for AVC groups 1 to 99, 100 to 299, and ≥300 compared with AVC = 0. Conclusions: The probability of AVC >0 varied significantly by age, sex, and race/ethnicity. The risk of severe AS was exponentially higher with higher AVC scores, whereas AVC = 0 was associated with an extremely low long-term risk of severe AS. The measurement of AVC provides clinically relevant information to assess an individual's long-term risk for severe AS.

Idioma originalEnglish (US)
Páginas (desde-hasta)31-42
Número de páginas12
PublicaciónJACC: Cardiovascular Imaging
EstadoAccepted/In press - 2023

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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