Abstract 14087: Mitral Annular Calcification and Non-Cardiovascular Outcomes: The Multi-Ethnic Study of Atherosclerosis

Abstract

Introduction: Mitral annular calcification (MAC) may be a maker for biological aging. A few studies have showed an association with non-cardiovascular events. We evaluated the association of MAC presence and severity with incident renal failure (RF) and incident dementia in a multiethnic population. Methods: We used data from 6,814 participants in the Multi-Ethnic Study of Atherosclerosis without cardiovascular disease at baseline [53% females, mean age 62 ±10 years; 12% Chinese, 38% White, 22% Hispanic, 28% African American]. MAC [absent/present; 0, 1-99, and ≥100; and <100/≥100 Agatston Units (AU)] was assessed with non-contrast cardiac CT at study baseline. Using multivariable-adjusted Cox proportional hazard regression, we evaluated the association of MAC with RF and incident dementia defined by dementia hospitalizations/death. Results: MAC prevalence was 9.5%; 10.7% in women; 8.0% in men. After a mean follow-up of 13 ± 4 years, individuals with MAC had a higher incidence rate of RF when compared to those without (17.9 vs. 8.1 per 1000 person-years). The incidence rate of RF increased with increasing MAC severity - MAC = 1-99 and MAC ≥ 100 (14.7 and 22.2 per 1000 person-years, respectively). Compared to individuals without MAC, those with MAC ≥100 had a higher multivariable-adjusted risk of RF [Hazard Ratio (HR): 1.41; 95%CI: 1.07 - 1.84; Table 1A ). Also, persons with MAC had a higher incidence of dementia when compared to those without MAC (16.4 vs. 4.1 per 1000 person-years). Persons with MAC = 1-99 AU (HR: 1.38; 95%CI: 1.01 - 1.89) and MAC ≥100 AU (HR: 1.71; 95%CI: 1.25 - 2.33) had significantly higher hazards of incident dementia than those without MAC ( Table 1B ). Conclusion: MAC is independently associated with incident renal failure and dementia in this multiethnic cohort. These findings underscore the utilization of MAC as an important marker of aging and risk of non-cardiovascular outcomes.