What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Chest pain referred for computed tomography to exclude coronary artery disease (n=499). Intervention: Age > 70 years vs. Age ≤ 70 years. Primary outcome: Prevalence of aortic valve calcification (p=0.0002).

January 1, 2015Open Access

Clinical research Aortic valve calcification in 499 consecutive patients referred for computed tomography

Key Result

Aortic valve calcification was found in 28.9% of patients referred for CT, with a significantly higher prevalence in patients over 70 years of age compared to younger patients (37.2% vs 22.1%, p=0.0002).

Study Design

Type

Cross-Sectional (n=499)

Multicenter

PICO

Population

499 patients aged 60 years and older referred for coronary computed tomography due to chest pain, evaluated for aortic valve, coronary artery, and ascending aorta calcifications.

Exposure / Comparator

Age > 70 years vs Age ≤ 70 years

Primary Outcome

Prevalence of aortic valve calcification, p=0.0002

Main Result

Absolute Event Rate: 37.2% vs 22.1%

p-value: p=0.0002

Limitations

Data collection was confined to a single center.
Study exclusively included patients referred for coronary artery diagnostics because of chest pain.
Excluded patients below 60 years of age, with kidney failure, or with previously diagnosed aortic valve disease.
Coronary CT angiography was not performed if CAC was > 1000 AU.

Abstract

INTRODUCTION: Aortic valve calcification (AVC) is the most common cause of aortic stenosis. The aim of the study was to assess the prevalence of aortic valve, coronary artery and aortic calcifications and to evaluate the correlation between calcification of the aortic valve, coronary arteries and aorta. MATERIAL AND METHODS: The study included 499 patients aged 60 years and over who underwent coronary computed tomography because of chest pain. Beside coronary artery calcium score (CAC), we evaluated AVC and ascending aorta calcifications (AAC). RESULTS: Aortic valve calcification was found in 144 subjects (28.9% of the whole study population). Prevalence of CAC and AAC was higher than AVC and amounted to 73.8% and 54.0%. Prevalence of AVC, CAC and AAC was significantly lower in the group of patients ≤ 70 years than in the group of patients > 70 years of age (p = 0.0002, p < 0.0001, p < 0.0001). Aortic valve calcification was more often observed in men than women (34.7% vs. 25.4%, p = 0.02). Degree of aortic valve calcification was also significantly higher among men than women (median score 4 vs. 0, p = 0.01). Similar observations were true for CAC and AAC, where both prevalence and degree of calcification was higher among men than women. In the whole study population no correlation was noted between AVC and CAC or AAC (p = 0.34, p = 0.85). There was a significant correlation between AAC and CAC (p < 0.0001). CONCLUSIONS: Despite some similarities in pathological mechanism and risk factors, a degenerative defect of the aortic valve could be independent of atheromatous lesions in the coronary arteries and aorta.

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