Risk Factors for the Development and Progression of Thoracic Aorta Calcification

The Multi-Ethnic Study of Atherosclerosis

George Youssef, Mengye Guo, Robyn L. McClelland, David M. Shavelle, Khurram Nasir, Juan Rivera, J. Jeffrey Carr, Nathan D. Wong, Matthew J. Budoff

Research output: Contribution to journalArticle

Abstract

Rationale and Objectives: Vascular calcification independently predicts cardiovascular disease (CVD), and computed tomography (CT) is a useful tool to evaluate and quantify not only coronary but also thoracic aortic calcification (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 multiethnic cohort without clinically evident CVD at entry. Methods: Non-contrast-enhanced cardiac CTs were obtained in 5886 of 6814 Multi-Ethnic Study of Atherosclerosis (MESA) participants (mean age, 62 years; 48% males; 40% white, 27% black, 21% Hispanic, and 12% Chinese). Baseline and follow-up TAC scores were derived. Results: Overall, 4308 (73%) participants had no detectable baseline TAC. Mean follow-up duration was 2.4 ± 0.8 years, during which 12% developed TAC. The overall incidence rate was 4.8%/year and was greater with age across gender and ethnic groups; TAC incidence was significantly lower in blacks than whites. After adjustment for follow-up duration, regression analyses showed age, systolic blood pressure, antihypertensives, and smoking were associated with incident TAC. A total of 1578 (27%) participants had TAC at baseline with a positive association between average annual TAC change and baseline age. Although the overall median change was 32.9 (-1.4 to 112.2) Agatston units, 27% showed an annual score change of ≥100 and blacks showed the lowest median across ethnic groups; 22.7 (-3 to 86.8). Age, systolic blood pressure, lipid-lowering medication, diabetes, and smoking were associated with TAC progression. Conclusions: In MESA, traditional CV risk factors were related to both TAC incidence and progression. Blacks had the lowest incidence and median change across ethnic groups, consistent with previous findings for coronary calcification.

Original languageEnglish (US)
Pages (from-to)1536-1545
Number of pages10
JournalAcademic Radiology
Volume22
Issue number12
DOIs
StatePublished - Dec 1 2015

Fingerprint

Thoracic Aorta
Atherosclerosis
Thorax
Ethnic Groups
Blood Pressure
Incidence
Cardiovascular Diseases
Smoking
Vascular Calcification
Hispanic Americans
Antihypertensive Agents
Renal Dialysis
Tomography
Regression Analysis
Transplants
Lipids

Keywords

  • Cardiac computed tomography
  • Cardiovascular events
  • Progression
  • Thoracic calcification
  • Vascular calcification

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Youssef, G., Guo, M., McClelland, R. L., Shavelle, D. M., Nasir, K., Rivera, J., ... Budoff, M. J. (2015). Risk Factors for the Development and Progression of Thoracic Aorta Calcification: The Multi-Ethnic Study of Atherosclerosis. Academic Radiology, 22(12), 1536-1545. https://doi.org/10.1016/j.acra.2015.08.017

Risk Factors for the Development and Progression of Thoracic Aorta Calcification : The Multi-Ethnic Study of Atherosclerosis. / Youssef, George; Guo, Mengye; McClelland, Robyn L.; Shavelle, David M.; Nasir, Khurram; Rivera, Juan; Carr, J. Jeffrey; Wong, Nathan D.; Budoff, Matthew J.

In: Academic Radiology, Vol. 22, No. 12, 01.12.2015, p. 1536-1545.

Research output: Contribution to journalArticle

Youssef, G, Guo, M, McClelland, RL, Shavelle, DM, Nasir, K, Rivera, J, Carr, JJ, Wong, ND & Budoff, MJ 2015, 'Risk Factors for the Development and Progression of Thoracic Aorta Calcification: The Multi-Ethnic Study of Atherosclerosis', Academic Radiology, vol. 22, no. 12, pp. 1536-1545. https://doi.org/10.1016/j.acra.2015.08.017
Youssef, George ; Guo, Mengye ; McClelland, Robyn L. ; Shavelle, David M. ; Nasir, Khurram ; Rivera, Juan ; Carr, J. Jeffrey ; Wong, Nathan D. ; Budoff, Matthew J. / Risk Factors for the Development and Progression of Thoracic Aorta Calcification : The Multi-Ethnic Study of Atherosclerosis. In: Academic Radiology. 2015 ; Vol. 22, No. 12. pp. 1536-1545.
@article{6aed22e525414442b52161af68b05c8c,
title = "Risk Factors for the Development and Progression of Thoracic Aorta Calcification: The Multi-Ethnic Study of Atherosclerosis",
abstract = "Rationale and Objectives: Vascular calcification independently predicts cardiovascular disease (CVD), and computed tomography (CT) is a useful tool to evaluate and quantify not only coronary but also thoracic aortic calcification (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 multiethnic cohort without clinically evident CVD at entry. Methods: Non-contrast-enhanced cardiac CTs were obtained in 5886 of 6814 Multi-Ethnic Study of Atherosclerosis (MESA) participants (mean age, 62 years; 48{\%} males; 40{\%} white, 27{\%} black, 21{\%} Hispanic, and 12{\%} Chinese). Baseline and follow-up TAC scores were derived. Results: Overall, 4308 (73{\%}) participants had no detectable baseline TAC. Mean follow-up duration was 2.4 ± 0.8 years, during which 12{\%} developed TAC. The overall incidence rate was 4.8{\%}/year and was greater with age across gender and ethnic groups; TAC incidence was significantly lower in blacks than whites. After adjustment for follow-up duration, regression analyses showed age, systolic blood pressure, antihypertensives, and smoking were associated with incident TAC. A total of 1578 (27{\%}) participants had TAC at baseline with a positive association between average annual TAC change and baseline age. Although the overall median change was 32.9 (-1.4 to 112.2) Agatston units, 27{\%} showed an annual score change of ≥100 and blacks showed the lowest median across ethnic groups; 22.7 (-3 to 86.8). Age, systolic blood pressure, lipid-lowering medication, diabetes, and smoking were associated with TAC progression. Conclusions: In MESA, traditional CV risk factors were related to both TAC incidence and progression. Blacks had the lowest incidence and median change across ethnic groups, consistent with previous findings for coronary calcification.",
keywords = "Cardiac computed tomography, Cardiovascular events, Progression, Thoracic calcification, Vascular calcification",
author = "George Youssef and Mengye Guo and McClelland, {Robyn L.} and Shavelle, {David M.} and Khurram Nasir and Juan Rivera and Carr, {J. Jeffrey} and Wong, {Nathan D.} and Budoff, {Matthew J.}",
year = "2015",
month = "12",
day = "1",
doi = "10.1016/j.acra.2015.08.017",
language = "English (US)",
volume = "22",
pages = "1536--1545",
journal = "Academic Radiology",
issn = "1076-6332",
publisher = "Elsevier USA",
number = "12",

}

TY - JOUR

T1 - Risk Factors for the Development and Progression of Thoracic Aorta Calcification

T2 - The Multi-Ethnic Study of Atherosclerosis

AU - Youssef, George

AU - Guo, Mengye

AU - McClelland, Robyn L.

AU - Shavelle, David M.

AU - Nasir, Khurram

AU - Rivera, Juan

AU - Carr, J. Jeffrey

AU - Wong, Nathan D.

AU - Budoff, Matthew J.

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Rationale and Objectives: Vascular calcification independently predicts cardiovascular disease (CVD), and computed tomography (CT) is a useful tool to evaluate and quantify not only coronary but also thoracic aortic calcification (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 multiethnic cohort without clinically evident CVD at entry. Methods: Non-contrast-enhanced cardiac CTs were obtained in 5886 of 6814 Multi-Ethnic Study of Atherosclerosis (MESA) participants (mean age, 62 years; 48% males; 40% white, 27% black, 21% Hispanic, and 12% Chinese). Baseline and follow-up TAC scores were derived. Results: Overall, 4308 (73%) participants had no detectable baseline TAC. Mean follow-up duration was 2.4 ± 0.8 years, during which 12% developed TAC. The overall incidence rate was 4.8%/year and was greater with age across gender and ethnic groups; TAC incidence was significantly lower in blacks than whites. After adjustment for follow-up duration, regression analyses showed age, systolic blood pressure, antihypertensives, and smoking were associated with incident TAC. A total of 1578 (27%) participants had TAC at baseline with a positive association between average annual TAC change and baseline age. Although the overall median change was 32.9 (-1.4 to 112.2) Agatston units, 27% showed an annual score change of ≥100 and blacks showed the lowest median across ethnic groups; 22.7 (-3 to 86.8). Age, systolic blood pressure, lipid-lowering medication, diabetes, and smoking were associated with TAC progression. Conclusions: In MESA, traditional CV risk factors were related to both TAC incidence and progression. Blacks had the lowest incidence and median change across ethnic groups, consistent with previous findings for coronary calcification.

AB - Rationale and Objectives: Vascular calcification independently predicts cardiovascular disease (CVD), and computed tomography (CT) is a useful tool to evaluate and quantify not only coronary but also thoracic aortic calcification (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 multiethnic cohort without clinically evident CVD at entry. Methods: Non-contrast-enhanced cardiac CTs were obtained in 5886 of 6814 Multi-Ethnic Study of Atherosclerosis (MESA) participants (mean age, 62 years; 48% males; 40% white, 27% black, 21% Hispanic, and 12% Chinese). Baseline and follow-up TAC scores were derived. Results: Overall, 4308 (73%) participants had no detectable baseline TAC. Mean follow-up duration was 2.4 ± 0.8 years, during which 12% developed TAC. The overall incidence rate was 4.8%/year and was greater with age across gender and ethnic groups; TAC incidence was significantly lower in blacks than whites. After adjustment for follow-up duration, regression analyses showed age, systolic blood pressure, antihypertensives, and smoking were associated with incident TAC. A total of 1578 (27%) participants had TAC at baseline with a positive association between average annual TAC change and baseline age. Although the overall median change was 32.9 (-1.4 to 112.2) Agatston units, 27% showed an annual score change of ≥100 and blacks showed the lowest median across ethnic groups; 22.7 (-3 to 86.8). Age, systolic blood pressure, lipid-lowering medication, diabetes, and smoking were associated with TAC progression. Conclusions: In MESA, traditional CV risk factors were related to both TAC incidence and progression. Blacks had the lowest incidence and median change across ethnic groups, consistent with previous findings for coronary calcification.

KW - Cardiac computed tomography

KW - Cardiovascular events

KW - Progression

KW - Thoracic calcification

KW - Vascular calcification

UR - http://www.scopus.com/inward/record.url?scp=84948720962&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84948720962&partnerID=8YFLogxK

U2 - 10.1016/j.acra.2015.08.017

DO - 10.1016/j.acra.2015.08.017

M3 - Article

VL - 22

SP - 1536

EP - 1545

JO - Academic Radiology

JF - Academic Radiology

SN - 1076-6332

IS - 12

ER -