Abstract P376: Risk Factors for the Progression and Incidence of Aortic Calcification in an International Multi-ethnic Cohort of Men Aged 40-49 Years: ERA JUMP Study

Abstract

Background: Aortic calcification (AC) is independently related to cardiovascular (CV) disease mortality. No previous study has examined associations of risk factors with the progression of calcification in the entire aorta. Methods: 1033 men aged 40-49 years without overt CV diseases from the ERA-JUMP cohort were examined for AC, CV risk and other factors in 2002-07 with rigid standardization with a median follow-up of 5.9 years. AC was assessed by electron-beam CT and was quantified using the Agatston’s method. We defined annual AC progression as the absolute difference of Agatston score divided by follow-up time in years, which was further dichotomized at the 80th percentile: ≥100/year vs. <100/year. In participants free of detectable AC at baseline, AC incidence was calculated. Logistic regressions were performed to analyze the association of risk factors with both annual AC progression and AC incidence. AC progression was adjusted for baseline AC and AC incidence was adjusted for follow-up time. Results: After excluding missing data (n=287) and extreme outliers (n=10), our sample included: 234 Caucasian, 53 African American, 207 Japanese American and 242 Japanese in Japan. AC was present in 55.3% (407 out of 736) at baseline. Baseline mean (SD) of age, pack-years of smoking, systolic blood pressure (SBP), BMI, LDL-C and AC Agatston score were 45.3 (2.9) years, 9.1 (14.0) pack-year, 124.5 (13.4) mmHg, 26.6 (4.6) Kg/m2, 129.7 (33.9) mg/dl and 103.0 (336.8), respectively. Overall analysis showed that baseline BMI, smoking, SBP and diabetes were significant or marginally significant determinants of AC progression (table 1). Incidence analysis showed that baseline smoking, SBP and LDL-C were significant or marginally significant determinants of AC incidence. Japanese in Japan displayed significantly lower incidence as well as progression. Conclusion: Both AC progression and incidence were closely related to multiple traditional CV risk factors, most significant for pack-years of smoking and blood pressure.