Abstract
Objective: To evaluate risk factors for the incidence and progression of thoracic aorta calcification (TAC) Introduction : Vascular calcification independently predicts cardiovascular disease (CVD) and computed tomography (CT) is a useful tool to evaluate and quantify TAC. Previous TAC progression reports were limited to dialysis and renal transplant patients, This is the first study to evaluate TAC progression in a large multi-ethnic cohort without clinically evident CVD at entry Methods: Non-contrast enhanced cardiac CT (EBCT or MSCT) were obtained in 5886 of the 6814 MESA participants (mean age 62 yrs; 48% male; 40% white, 27% African American (AA), 21% Hispanic, 12% Chinese. Baseline (BL) and follow up (FU) TAC scores were derived Results: 4308 (73%) subjects had no detectable BL TAC. Mean FU duration was 2.4±0.8 yrs, during which 12% developed TAC. The overall incidence rate was 4.8%/yr and was greater with age across gender and ethnic groups,TAC incidence was significantly lower in AA than whites. Regression analyses showed FU time, age, systolic BP, antihypertensives, and smoking were predictors of incident TAC. 1578 (27%) subjects had prevalent TAC at BL scan with a positive association between the averaged annual TAC change and BL age. While the overall median (25 th , 75 th %tiles) change was 32.9 (-1.4,112.2) Agatston units, 38% of study population showed an annual Agatston score progression change of 10-99 and AA showed the lowest median across all ethnic groups; 22.7 (-3,86.8). Regression analyses showed MSCT use, FU time, age, systolic BP, lipid-lowering medication, DM and current smoking were predictors of TAC progression (Tab1) Conclusion: In the MESA cohort, both TAC incidence and progression were significantly associated with traditional CV risk factors. AA had the lowest incidence and median change across ethnic groups, consistent with previous findings for coronary calcification. Further studies are needed to correlate progression with outcome data
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