Abstract 13328: Mitral Annular Calcification and All-Cause, Cardiovascular, and Non-Cardiovascular Mortality in a Multiracial Cohort: The Multi-Ethnic Study of Atherosclerosis

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Introduction: Mitral annular calcification (MAC) may be a potential marker of biological aging. However, the relative association of MAC with mortality, including all-cause, cardiovascular, and non-cardiovascular mortality in a multiracial cohort, is not well studied. Methods: We used data from 6814 men and women (mean age 62.2 ±10.2 years; 12% Chinese, 38% White, 22% Hispanic, and 28% African American) without CVD at baseline in the Multi-Ethnic Study of Atherosclerosis. MAC (absent/present and <100/≥100 AU) was assessed with non-contrast cardiac computed tomography at baseline. Using multivariable-adjusted Cox proportional hazard and competing risks regression, we evaluated the association of MAC with all-cause, and cardiovascular and non-cardiovascular mortality, respectively. Results: The prevalence of MAC was 9.5% and was higher in women (10.7%) than men (8.0%). Compared to persons without MAC, those with MAC > 0 had higher incidence rate of all-cause (13.6 vs. 41.2 per 1000 person-years), cardiovascular (3.1 vs. 11.0 per 1000 person-years), and non-cardiovascular mortality (9.9 vs. 28.7 per 1000 person-years) over a mean follow-up of 14.4 ± 3.7 years. Persons with MAC > 0 had significantly higher multivariable-adjusted risk of all-cause (Hazard Ratio [HR]: 1.51; 95%CI: 1.32 - 1.72), cardiovascular (SHR: 1.46; 95%CI: 1.09 - 1.95), and non-cardiovascular mortality (SHR: 1.37; 95%CI: 1.16 - 1.61), compared to those without MAC. Similarly, compared to MAC <100 AU, MAC ≥100 was associated with a 1.82 (1.53 - 2.15), 1.55 (1.07 - 2.25), and 1.62 (1.30 - 2.01)-fold increased hazard of all-cause, cardiovascular, and non-cardiovascular mortality, respectively ( Figure ). Conclusions: In this multiracial cohort, MAC was associated with all-cause, cardiovascular, and non-cardiovascular mortality. Thus, MAC may be a marker not only for atherosclerotic burden but also for other metabolic and inflammatory factors that increase the risk of death from other causes.