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Calcified Atherosclerosis in Different Vascular Beds and the Risk of Mortality
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Methods and Results—A total of 4544 patients underwent computed tomography scans that were interrogated for calcium in different vascular beds. Mortality assessment was conducted by death certificate adjudication. At baseline, the mean age was 56.8 years, and 43% were female. After an average of 7.8 years, there were 163 deaths. With full adjustment, the presence of calcium in the thoracic aorta (hazard ratio [HR], 2.1; 95% confidence interval [CI], 1.2–3.5), carotids (HR, 1.60; CI, 1.1–2.5), and iliac (HR, 1.67; CI, 1.0–2.9) arteries were associated with total mortality, whereas the presence of coronary calcium was associated with cardiovascular disease (CVD) mortality (HR, 3.4; CI, 0.8–10.9). For severity of calcium burden, a 1-SD increment in the iliac arteries was the strongest predictor for all types of mortality. C-statistics were not significantly larger when noncoronary vascular beds were added to models with CVD risk factors or CVD risk factors plus coronary artery calcium.
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In conclusion, the results of this study indicate that higher levels of calcium in different vascular beds are associated not only with CVD mortality but also with non-CVD and total mortality. Moreover, the location of the arterial calcification appears to be relevant to the strength of the association with mortality, and the CVD risk factors appear to mediate some of this association. Notably, there are current recommendations and guidelines for the use of CAC in the CVD risk stratification.24 Given the results of the current study, future research is warranted to determine whether current recommendations on CAC measurements should be expanded to include calcium in other vascular beds..
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Estudo demonstra que ter Cálcio em qualquer artéria implica em complicações cardiovasculares.
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Assim como a IMT da artéria femural, Cálcio nas Ilíacas oferece risco aumentado.
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Arteriosclerosis, Thrombosis, and Vascular Biology.2012; 32: 140-146
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