Original ResearchPrevalence of Aortic Valve Calcium and the Long-Term Risk of Incident Severe Aortic Stenosis
Central Illustration
Section snippets
Study participants
A total of 6,812 participants from MESA had noncontrast cardiac CT performed at visit 1 (2000-2002) with AVC scoring. Participants 45 to 84 years of age who were free of clinically apparent CVD were recruited from 6 communities within the United States who self-identified their race/ethnicity as White, Black, Hispanic, or Chinese.8 The MESA protocol was approved by the Institutional Review Boards at the participating institutions, and written informed consent was given by all participants.
Quantification of AVC
Results
The mean age of participants was 62.1 ± 10.2 years of age, and 53% were women. Overall, there were 913 participants (13.4%) with AVC >0. Participants with AVC >0 were approximately 10 years older on average than participants with AVC = 0 and had a higher burden of traditional CVD risk factors (Table 1). Among participants with AVC >0, 211 (23%) had AVC between 100 and 299 AU, and 114 (13%) had AVC ≥300 AU (Figure 1).
The probability of AVC >0 was higher with older age for both men and women in a
Discussion
To the best of our knowledge, this is the first report to: 1) provide age, sex, and race/ethnicity reference AVC percentiles from a community-based sample of people free of CVD from the United States; and 2) examine the association of CT-measured AVC with the long-term risk for adjudicated severe AS. Our results provide the foundation for a reference tool highlighting the importance of age, sex, and race/ethnicity in the clinical interpretation of AVC scoring. They also provide a robust
Conclusions
These results provide the first age-, sex-, and race/ethnicity-specific reference values for AVC, which will help inform cutoffs for defining an elevated AVC score and provide an important framework for the clinical interpretation of AVC scores. These results also demonstrate that AVC is very strongly associated with the long-term risk for adjudicated severe AS and that the risk increases exponentially with higher AVC scores. Of similar importance, AVC = 0 is associated with an exceptionally
Funding Support and Author Disclosures
This research was supported by R01 HL071739, and MESA was supported by contracts 75N92020D00001, HHSN268201500003I, N01-HC-95159, 75N92020D00005, N01-HC-95160, 75N92020D00002, N01-HC-95161, 75N92020D00003, N01-HC-95162, 75N92020D00006, N01-HC-95163, 75N92020D00004, N01-HC-95164, 75N92020D00007, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169 from the National Heart, Lung, and Blood Institute and by grants UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420 from the National
Acknowledgments
The authors thank the other investigators, the staff, and the participants of the MESA study for their valuable contributions. A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org.
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