P751Cardiovascular sclerocalcifications- a potential marker of coexisting coronary disease in a low to intermediate risk albanian population


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Abstract

Aortic valve sclerocalcification (AVSC) and mitral annulus calcification (MAC) is common with aging and have been considered as a manifestation of generalized atherosclerosis in elderly population. However, the significance of these calcifications in younger populations has not been previously determined. AVSC and MAC can be easily detected by transthoracic echocardiography (TTE).Recently, Coronary CT angiography (CTA) has become widely available in detecting early coronary atherosclerosis disease (CAD).Methods: In a prospective, cohort study, we identified patients who all underwent both CCTA and TTE for various clinical indications. We utilized abnormal CTA as a surrogate for angiographically CAD. All known risk factors for atherosclerosis were also investigated.Results: The mean age of our study population included 155 patients was 57+-11.28 years. These patients were divided in two groups: 91(58.7%) in the AVSC group and 64(41.3%) in the control group. The two groups had similar clinical risk factors.Of the 91 patients with AVSC, 69(75,8%) were found to have CAD compared with 12 of the 64 patients (19%) without (p<0,001). So, the AVSC group had a higher prevalence of positive CT for the presence of CAD and a higher incidence rate of multivessel disease than the control group. MAC also was found to be significantly more prevalent in the AVSC group than in the control group (92.6 vs 7.4%) with p<0.001.When the cohort was divided by the presence of atherosclerosis, we found that 81patients had CAD and 74 had normal coronary arteries (75.8 vs 24.2%). Of the 81 patients with CAD, 69 had AVSC compared with 22 in the non- CAD group (p<0.001).Hypertension and MAC were found significantly more prevalent in the CAD group than in non-CAD group, respectively (61vs39%, with p=0.006 and 70.4 vs 29.6, with p=0,042).Logistic regression analysis showed that AVSC was strongly and significantly associated with CAD after adjusting for all coronary risk factors, except age (OR = 6,637; 95% CI 2,5-7,464, p<0.001). Multivariate analysis identified only AVSC and age as independent predictors of coronary atherosclerosis. The sensitivity, specificity, positive and negative predictive values for AVSC in diagnosing CAD were 85.1%, 69.8%, 75.8% and 81%, respectively.Conclusion: Our study demonstrates that aortic valve sclerocalcification and coronary atherosclerosis are significantly associated with each other even in a low - intermediate risk population (EURO SCORE 5-10%), otherwise their presences in TTE may help in predicting early CAD and should be added to conventional risk factors.

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