Key result
Mitral annular calcification was associated with a higher risk of all-cause death (HR 1.76; 95% CI 1.43-2.22) and cardiovascular mortality (HR 1.85; 95% CI 1.45-23.5).
Why the study?
Mitral annular calcification is prevalent in the aging population, but its relationships with cardiovascular mortality, morbidity events, and valvular interventions needed systematic reporting.
Does the presence of mitral annular calcification increase the risk of cardiovascular mortality and morbidity events?
Meta-Analysis (n=35,070)
Does the presence of mitral annular calcification increase the risk of cardiovascular mortality and morbidity events?
Hazard Ratio: 1.76 (95% CI 1.43–2.22)
Mitral annular calcification is significantly associated with increased risks of all-cause mortality, cardiovascular mortality, and major cardiovascular events, highlighting its importance in cardiovascular risk assessment.
May inform echocardiographic risk stratification; confirms association with mortality but leaves open causality and intervention targets.
BACKGROUND: Mitral annular calcification (MAC) is prevalent in the aging population, with recent renewed interest regarding its associations with cardiovascular risk factors, outcomes, and influence on valvular heart disease and interventions. This meta-analysis aimed to report the relationships between MAC and cardiovascular mortality and morbidity events. METHODS: Relevant studies were searched from PubMed, Cochrane, and Embase databases until November 30, 2019. Associations between MAC as a binary variable with death and cardiovascular events were pooled using random-effects models. The main outcomes of interest were all-cause and cardiovascular mortality, myocardial infarction, stroke, heart failure, atrial fibrillation, and procedural outcomes. RESULTS: Among 799 article abstracts and 122 full-text articles screened, 26 (16 prospective and 10 retrospective) studies totaling 35 070 subjects were analyzed. MAC was associated with higher all-cause death, hazard ratio (95% confidence interval) 1.76 (1.43-2.22), and cardiovascular mortality 1.85 (1.45-23.5). It also positively correlated with myocardial infarction 1.48 (1.22-1.79), stroke 1.51 (1.22-2.05), incidental heart failure 1.55 (1.30-1.84), atrial fibrillation 1.75 (1.43-2.15), and their composite, major adverse cardiovascular events (MACE). Finally, conversion to mitral valve replacement at time of cardiac surgery was more in patients with MAC than without MAC, with odds ratio (95% confidence interval) 2.82 (1.28-6.18). CONCLUSION: Mitral annular calcification was overall associated with higher rates of death, and both individual and composite cardiovascular events. The presence of increasingly encountered MAC has significant clinical implications for cardiovascular risk assessment and valvular interventions.
No takes yet. Share an insight, caveat, or question.
Wang et al. (2020) conducted a meta-analysis in Mitral annular calcification (n=35,070). Mitral annular calcification vs. Without mitral annular calcification was evaluated on All-cause death (HR 1.76, 95% CI 1.43-2.22). Mitral annular calcification was associated with a higher risk of all-cause death (HR 1.76; 95% CI 1.43-2.22) and cardiovascular mortality (HR 1.85; 95% CI 1.45-23.5).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: