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Editor's Choice - Calcification of Thoracic and Abdominal Aneurysms is Associated with Mortality and Morbidity.

Published version
Peer-reviewed

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Authors

Chowdhury, Mohammed M 
Zieliński, Lukasz P 
Sun, James J 
Lambracos, Simon 
Boyle, Jonathan R 

Abstract

INTRODUCTION: Cardiovascular events are common in people with aortic aneurysms. Arterial calcification is a recognised predictor of cardiovascular outcomes in coronary artery disease. Whether calcification within abdominal and thoracic aneurysm walls is correlated with poor cardiovascular outcomes is not known. PATIENTS AND METHODS: Calcium scores were derived from computed tomography (CT) scans of consecutive patients with either infrarenal (AAA) or descending thoracic aneurysms (TAA) using the modified Agatston score. The primary outcome was subsequent all cause mortality during follow-up. Secondary outcomes were cardiovascular mortality and morbidity. RESULTS: A total of 319 patients (123 TAA and 196 AAA; median age 77 [71-84] years, 72% male) were included with a median follow-up of 30 months. The primary outcome occurred in 120 (37.6%) patients. In the abdominal aortic aneurysm group, the calcium score was significantly related to both all cause mortality and cardiac mortality (odds ratios (OR) of 2.246 (95% CI 1.591-9.476; p < 0.001) and 1.321 (1.076-2.762; p = 0.003)) respectively. In the thoracic aneurysm group, calcium score was significantly related to all cause mortality (OR 6.444; 95% CI 2.574-6.137; p < 0.001), cardiac mortality (OR 3.456; 95% CI 1.765-4.654; p = 0.042) and cardiac morbidity (OR 2.128; 95% CI 1.973-4.342; p = 0.002). CONCLUSIONS: Aortic aneurysm calcification, in either the thoracic or the abdominal territory, is significantly associated with both higher overall and cardiovascular mortality. Calcium scoring, rapidly derived from routine CT scans, may help identify high risk patients for treatment to reduce risk.

Description

Keywords

Atherosclerosis, Calcification, Computed tomography, Thoracic abdominal aortic aneurysm, Aged, Aged, 80 and over, Aortic Aneurysm, Abdominal, Aortic Aneurysm, Thoracic, Computed Tomography Angiography, Female, Humans, Male, Odds Ratio, Retrospective Studies, Risk Assessment, Tomography, X-Ray Computed, Vascular Calcification

Journal Title

Eur J Vasc Endovasc Surg

Conference Name

Journal ISSN

1078-5884
1532-2165

Volume Title

55

Publisher

Elsevier BV
Sponsorship
British Heart Foundation (None)
Academy of Medical Sciences (unknown)
British Heart Foundation (None)
Evelyn Trust (unknown)
Engineering and Physical Sciences Research Council (EP/N014588/1)
Medical Research Council (MR/N028015/1)
British Heart Foundation (FS/16/29/31957)