Thoracic aortic calcium ≥500 was significantly associated with increased risk of incident CVD (HR 1.28; 95% CI 1.06-1.54) and all-cause mortality (HR 1.44; 95% CI 1.25-1.65) compared to TAC=0.
Cohort (n=6,783)
Yes
Does thoracic aortic calcium (TAC) improve long-term cardiovascular disease and all-cause mortality risk stratification beyond coronary artery calcium (CAC) in asymptomatic individuals?
High thoracic aortic calcium (TAC ≥500) is associated with increased long-term risk for CVD and all-cause mortality, primarily improving risk stratification in individuals with a coronary artery calcium score of zero.
Effect estimate: HR 1.28 (95% CI 1.06-1.54)
Calcification of the ascending and/or descending thoracic aorta is easily measured via non-contrast cardiac computed tomography (CT), commonly performed for quantification of coronary artery calcium (CAC). We assessed whether thoracic aortic calcium (TAC) further improves long-term cardiovascular disease (CVD) risk stratification beyond CAC alone. Cardiac CT was performed among 6,783 asymptomatic Multi-Ethnic Study of Atherosclerosis participants at baseline. Cox proportional hazards regression assessed the association of TAC with incident CVD and all-cause mortality over a median follow-up of 17.7 years, adjusting for CVD risk factors and CAC. The mean age was 62.1 years old, 53% were female, and 28% had TAC. Over a median follow-up of 17.7 years, 48% of participants with TAC ≥500 experienced CVD and 72% died. Compared to TAC=0, TAC ≥500 was significantly associated with an increased risk of CVD (HR=1.28, 95% CI:1.06-1.54) and all-cause mortality (HR=1.44, 95% CI:1.25-1.65), with the strongest association among persons with CAC=0 (CVD HR=1.79, 95% CI: 1.04-3.07; all-cause mortality HR=1.82, 95% CI: 1.29-2.56). The addition of TAC to traditional risk factors and CAC did not improve CVD discrimination (ΔC-statistic=+0.002, p=0.12), but incrementally improved prediction of all-cause mortality (CVD: ΔC-statistic=+0.002, p=0.02). Participants with TAC ≥500 had a high long-term risk for CVD and all-cause mortality. TAC primarily improved risk stratification among persons with CAC=0.
Razavi et al. (Thu,) conducted a cohort in Asymptomatic individuals (n=6,783). Thoracic aortic calcium (TAC) ≥500 vs. TAC=0 was evaluated on Incident cardiovascular disease (HR 1.28, 95% CI 1.06-1.54). Thoracic aortic calcium ≥500 was significantly associated with increased risk of incident CVD (HR 1.28; 95% CI 1.06-1.54) and all-cause mortality (HR 1.44; 95% CI 1.25-1.65) compared to TAC=0.