The following is a summary of “Prevalence of Aortic Valve Calcium and the Long-Term Risk of Incident Severe Aortic Stenosis,” published in the January 2024 issue of Cardiology by Whelton et al.
Aortic stenosis (AS) is primarily driven by aortic valve calcification (AVC), a critical underlying mechanism. Researchers conducted a retrospective study to determine AVC prevalence and the link to long-term severe AS risk.
They conducted non-contrast cardiac computed tomography on 6,814 participants without known cardiovascular disease during the first visit to the Multi-Ethnic Study of Atherosclerosis (MESA). AVC levels were measured using the Agatston method, and normative percentiles for AVC were determined based on age, sex, and race/ethnicity. Severe AS cases were identified through chart reviews of hospital visits and supplemented with echocardiographic data from the sixth visit. The association between AVC and the long-term incidence of severe AS was analyzed using multivariable Cox HR.
The results showed 913 AVC participants, constituting 13.4% of the sample.The likelihood of AVC >0 and AVC scores rose with age, particularly among men and White participants. Generally, the probability of AVC >0 in women mirrored that of men of the same race/ethnicity who were roughly 10 years younger. During a median follow-up of 16.7 years, 84 participants experienced incidents adjudicated severe AS. Higher AVC scores demonstrated an exponential association with both the absolute and relative risks 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 to AVC = 0.
Investigators concluded that age, sex, and race influence AVC, a potent predictor of severe AS; absence of AVC offers near-zero risk.