Abdominal aortic calcification, cardiac troponin I and atherosclerotic vascular disease mortality in older women

ObjectiveExamine if two inexpensive measures of atherosclerotic vascular diseases (ASVD), abdominal aortic calcification (AAC) and high-sensitivity cardiac troponin I (hs-cTnI) provide complementary information for 10-year ASVD mortality and all-cause mortality risk in older women.Methods908 community-dwelling women without prevalent ASVD (≥75 years) were followed-up between 2003 and 2013. AAC and plasma hs-cTnI measures were obtained in 2003. AAC was assessed on lateral spine images using a semiquantitative method (AAC24). Linked health records were used for mortality outcomes.ResultsMean±SD age was 79.9±2.6 years. 276 (30.4%) women died during follow-up, including 138 (15.2%) ASVD-related deaths. AAC24 and hs-cTnI were independently associated with ASVD and all-cause mortality (p<0.001). The cohort was dichotomised into four groups: (1) low AAC24 (AAC24: 0 or 1) and <median hs-cTnI (n=163, referent), (2) moderate-extensive AAC24 (AAC24:>1) and <median hs-cTnI (n=280), (3) low AAC24 and ≥median hs-cTnI (n=148) and (4) moderate-extensive AAC24 and ≥median hs-cTnI (n=317). Compared with the referent group, a stepwise increase in relative hazard (HR (95% CI)) for ASVD mortality was seen at 2.39 (1.05 to 5.46), 3.18 (1.35 to 7.79) and 5.38 (2.44 to 11.85), respectively. A similar associations were observed for all-cause mortality, at 1.58 (0.99–2.52), 2.38 (1.46–3.89) and 3.02 (1.93–4.72), respectively (all p<0.05).ConclusionHigher AAC and elevated hs-cTnI were associated with higher risk of ASVD mortality and all-cause mortality, independent of each other. Stratifying by moderate to extensive AAC and elevated hs-cTnI identified women at very high risk. Further studies investigating whether combining factors may improve risk prediction are needed.Trial registration numberACTRN12617000640303.

Effects of Abdominal Aortic Calcification and Facet Joint Arthritis On Lumbar Bone Mineral Density Using Dual-Energy X-Ray Absorptiometry

Background Abdominal aortic calcification (AAC) may overestimate lumbar bone mineral density (BMD) examined by dual-energy X-ray absorptiometry (DXA); however, the degree of effect of AAC on lumbar BMD has not been quantified. In particular, no study has quantitatively compared and analysed segmental BMD and AAC using computed tomography (CT) scan. Thus, this study aimed to quantify the effect of AAC on BMD measurements using DXA via multiple linear regression analysis. Methods This study retrospectively reviewed participants >30 years of age who underwent DXA and spinal CT scans between 2014 and 2016. Variables that significantly affected the BMD of each lumbar segment were identified. Additionally, segmental facet joint arthritis (FJA) and AAC volume were evaluated using CT. Results A total of 620 subjects (153 males and 467 females) were included. The mean age was 71.6 ± 9.1 years (range, 31–89 years). AAC had the highest prevalence in L3 (45.2%), followed by L4 (41.1%). The average volume of AAC was the highest in L4 at 213.67 ± 443.82 mm3, followed by L3 at 161.95 ± 338.09 mm3. Our regression model found that Ln (L4BMD) was significantly correlated with age, BMI, FJA, and AAC volume in female subjects. Additionally, L4 BMD might be overestimated by approximately 0.90% for every 100 mm3 increase in AAC volume. The results for Ln (L3BMD) were almost identical. However, these relationships were not observed in males. Conclusion According to this model, AAC may overestimate lumbar BMD examined by DXA in a dose-dependent manner in females.

Relationship Between Parathyroid Hormone Levels and Abdominal Aortic Calcification in Incident Hemodialysis Patients Not Treated with Calcium or Vitamin D

Vascular calcification (VC) and secondary hyperparathyroidism (SHPT) are important causes of high incidence of cardiovascular events in chronic kidney disease (CKD) patients. The relationship between parathyroid hormone (PTH) and VC is very complex. Different studies have inconsistent reports on the effect of PTH on VC. The present study investigated the correlation between PTH levels and abdominal aortic calcification (AAC) in incident hemodialysis patients who did not receive calcium, calcium-containing phosphorus binders, calcitriol or vitamin D analogs. Our data confirm that serum PTH levels is significantly negatively correlated with AAC within a certain concentration range in incident hemodialysis patients who not treated with calcium or vitamin D.

Higher Blood Lead Level Is Associated With Increased Likelihood of Abdominal Aortic Calcification

Aims: This study aimed to evaluate the association between blood lead level (BLL) and abdominal aortic calcification (AAC) in US adults aged ≥40 years.Methods: We obtained data from 2013 to 2014 National Health and Nutrition Examination Survey (NHANES). Participants missing the data of BLL and AAC scores were excluded. BLL was measured using inductively coupled plasma mass spectrometry directly. AAC scores were quantified by Kauppila score system, and severe AAC was defined as AAC score &gt;6. Weighted multivariable regression analysis and subgroup analysis were conducted to explore the independent relationship between BLL with AAC score and severe AAC.Results: A total of 1,530 participants were included with the mean BLL of 1.45 ± 1.31 ng/dl and mean AAC score of 1.40 ± 3.13. The prevalence of severe AAC was 7.98% overall, and participants in higher BLL quartile showed higher prevalence of severe AAC (Quartile 1: 3.55%, Quartile 2: 7.28%, Quartile 3: 9.88%, Quartile 4: 12.58%, P &lt; 0.0001). BLL was positively associated with higher AAC score (β = 0.15, 95% CI: 0.02, 0.27, P = 0.021) and increased risk of severe AAC (OR = 1.11; 95% CI: 1.00–1.22; P = 0.047). Subgroup analysis and interaction test indicated that the association between BLL and AAC was similar in different population settings.Conclusions: Higher BLL was associated with higher AAC score and increased risk of severe AAC. Lead burden should be considered for people with AAC in clinical settings.

Associations between serum triglycerides and abdominal aortic calcification in a cross-sectional study from the United States of America

Background Abdominal aortic calcification (AAC) has recently been recognised as a risk factor for cardiovascular disease, as it shares pathophysiological mechanisms with coronary artery disease. Purpose We investigated relationships between AAC and traditional cardiovascular risk factors in a cross-sectional epidemiological cohort from the USA Methods We used data from the National Health and Nutrition Evaluation Survey (NHANES) from the years 2103–2014. Dual-energy X-ray absorptiometry (DXA scans) were performed for a subset of 3140 NHANES participants over the age of 40. The images were scored according to ACC-24, a 24-point scale. We performed binary logistic regression to investigate relationships between demographic variables (age, sex, poverty income ratio, & educational status) CV risk factors (triglycerides (fasting, and non-fasting) LDL-C, HDL-C systolic blood pressure, body mass index, smoking status & diabetes) medicine use (statins, antihypertensives and antiplatelets) and AAC status (patients with a score ≥2 on the 24-point scale were considered AAC positive). Non normally-distributed variables were categorised for the purposes of analysis. Results Participants with AAC were older (mean 65.5 years ± SD 11.7) than unaffected individuals (56.1±11.1) AAC was also associated with higher BMI (28.7±5.8 v. 27.6±4.8 kg/m2), and higher systolic blood pressure (131.3±19.5 v 125.8±18.4 mmHg). We found a strong relationship between plasma triglyceride concentrations and AAC. In univariate analysis, fasting triglycerides above the first quartile were associated with approximately double the risk of AAC, compared to those in the first quartile (see table). This relationship persisted when the analysis was adjusted for demographics, risk factors and medicine use. A similar pattern was seen with non-fasting triglycerides (see table). Conclusions We found a strong relationship between triglycerides and AAC. Further work is required to determine whether this observation can be validated in other cohorts, and whether interventions to reduce triglyceides can alter the progression of AAC. FUNDunding Acknowledgement Type of funding sources: None. Odds ratios (95% CI) for AAC

Greater Dietary Inflammatory Potential Is Associated With Higher Likelihood of Abdominal Aortic Calcification

Aims: We aimed to assess the association between dietary inflammation index (DII) and abdominal aortic calcification (AAC) in US adults aged ≥40 years.Methods: Data were obtained from the 2013–2014 National Health and Nutrition Examination Survey (NHANES). Participants who were &lt;40 years old and missing the data of DII and AAC were excluded. DII was calculated based on a 24-h dietary recall interview for each participant. AAC score was quantified by assessing lateral spine images and severe AAC was defined as AAC score &gt;6. Weighted multivariable regression analysis and subgroup analysis were preformed to estimate the independent relationship between DII with AAC score and severe AAC.Results: A total of 2,897 participants were included with the mean DII of −0.17 ± 2.80 and the mean AAC score of 1.462 ± 3.290. The prevalence of severe AAC was 7.68% overall, and participants in higher DII quartile tended to have higher rates of severe AAC (Quartile 1: 5.03%, Quartile 2: 7.44%, Quartile 3: 8.38%, Quartile 4: 10.46%, p = 0.0016). A positive association between DII and AAC score was observed (β = 0.055, 95% CI: 0.010, 0.101, p = 0.01649), and higher DII was associated with an increased risk of severe AAC (OR = 1.067, 95% CI: 1.004, 1.134, p = 0.03746). Subgroup analysis indicated that this positive association between DII and AAC was similar in population with differences in gender, age, BMI, hypertension status, and diabetes status and could be appropriate for different population settings.Conclusion: Higher pro-inflammatory diet was associated with higher AAC score and increased risk of severe AAC. Anti-inflammatory dietary management maybe beneficial to reduce the risk of AAC.