Abstract MP61: 1-year Prognosis By Coronary Artery And Extra-coronary Calcification In The 75-and-older Population

Abstract

Background: Coronary artery calcium (CAC) is one of the most potent predictors of cardiovascular disease (CVD). Also, thoracic extra-coronary calcification (ECC) (e.g., aortic valve calcification) has provided additional prognostic information beyond CAC. However, data on CAC and ECC as predictors of CVD outcomes are limited in individuals aged ≥75 years and rarely report near-term prognosis despite its importance in the 75-and-older population given life expectancy. Methods: In 1,672 ARIC participants (age 75-94 years) without history of clinical coronary heart disease (CHD) at visit 7 (2018-2019), we assessed the associations of CAC and ECC with CVD (including CHD, stroke, and heart failure) over a median follow-up of 1.1 (IQI 0.7-1.5) years (46 CVD total cases), using adjusted Cox models. CAC and ECC were modeled categorically (Agatston scores 0-99 [reference], 100-299, and 300+) and continuously (log[Agatston score+1]). Results: Higher scores of CAC and calcium in the aortic valve (only when modeled continuously) and ascending aorta were significantly associated with elevated risk of CVD (e.g., adjusted hazard ratio [HR]: 2.79 [95% CI 1.21, 6.44] for CAC 300+ and 5.90 [2.42, 14.39] for ascending aorta calcium 300+ vs. 0-99.) ( Table ). We confirmed consistent results after excluding participants with prevalent stroke, and the association of aortic valve calcium 300+ with CVD became statistically significant (HR 2.31 [95% CI 1.02, 5.24]. When each CVD outcome was analyzed separately, significant associations with CHD and heart failure were shown in CAC (only when modeled continuously) and ascending aorta calcium (e.g., 4.98 [95% CI 1.10, 22.58] for CHD and 6.88 [2.14, 22.04] in ascending aorta calcium 300+). Conclusions: Coronary artery, ascending aorta, and aortic valve calcifications were positively associated with 1-year risk of CVD in 75+ year old. Our results support the prognostic value of CAC and ECC even in very old adults and suggest distinct prognostic implications of different vascular beds.