Abdominal Aortic Calcification on Vertebral Morphometry Images Predicts Incident Myocardial Infarction

作者：Bolland Mark J^*; Wang Tom K M; van Pelt Niels C; Horne Anne M; Mason Barbara H; Ames Ruth W; Grey Andrew B; Ruygrok Peter N; Gamble Greg D; Reid Ian R

来源：Journal of Bone and Mineral Research, 2010, 25(3): 505-512.

DOI：10.1359/jbmr.091005

• AORTA
• CALCIFICATION
• MYOCARDIAL INFARCTION
• STROKE
• BONE DENSITOMETRY

Abdominal aortic calcification (AAC) measured on spine X-rays is an established risk factor for cardiovascular disease. We investigated whether AAC assessed using vertebral morphometry and a recently developed scoring system (AAC-8) is reliable and associated with cardiovascular risk factors or events. A total of 1471 healthy postmenopausal women and 323 healthy middle-aged and older men participated in 5 and 2 year trials of calcium supplements, respectively. AAC-8 was assessed on vertebral morphometry images at baseline and follow-up. In addition, 163 men also had coronary artery calcification measured using computed tomography. Cardiovascular events during the trials were independently adjudicated. We found strong inter- and intrameasurer agreement for AAC-8 (kappa > 0.87). The prevalence of AAC increased with age (p<.01) in women and in men. AAC was associated with many established cardiovascular risk factors, with serum calcium in women (p=.002) and with higher coronary calcium scores in men (p=.03). Estimated 5 year cardiovascular risk increased with increasing AAC-8 score (p<.001) in women and in men. The presence of AAC independently predicted myocardial infarction (MI) in women [hazards ratio (HR) = 2.30, p=.007] and men (HR = 5.32, p=.04), even after adjustment for estimated cardiovascular risk in women. In women, AAC independently predicted cardiovascular events (MI, stroke, or sudden death) (HR = 1.74,p=.007), and changes in AAC-8 score over time were associated with MI and cardiovascular events, even after adjustment for estimated cardiovascular risk. In summary, scoring AAC on vertebral morphometric scans is a reproducible method of assessing cardiovascular risk that independently predicts incident MI and cardiovascular events, even after taking into account traditional cardiovascular risk factors.

• 出版日期2010-3