Objective Aortic valve calcification (AVC) and coronary artery calcification (CAC) are predictors of cardiovascular disease (CVD), presumably sharing risk factors. Our objectives were to determine the prevalence and extent of AVC in a large population of men aged 60–74 years and to assess the association between AVC and cardiovascular risk factors including CAC and biomarkers.
Methods Participants from the DANish CArdioVAscular Screening and intervention trial (DANCAVAS) with AVC and CAC scores and without previous valve replacement were included in the study. Calcification scores were calculated on non-contrast CT scans. Cardiovascular risk factors were self-reported, measured or both, and further explored using descriptive and regression analysis for AVC association.
Results 14 073 men aged 60–74 years were included. The AVC scores ranged from 0 to 9067 AU, with a median AVC of 6 AU (IQR 0–82). In 8156 individuals (58.0%), the AVC score was >0 and 215 (1.5%) had an AVC score ≥1200. In the regression analysis, all cardiovascular risk factors were associated with AVC; however, after inclusion of CAC ≥400, only age (ratio of expected counts (REC) 1.07 (95% CI 1.06 to 1.09)), hypertension (REC 1.24 (95% CI 1.09 to 1.41)), obesity (REC 1.34 (95% CI 1.20 to 1.50)), known CVD (REC 1.16 (95% CI 1.03 to 1.31)) and serum phosphate (REC 2.25 (95% CI 1.66 to 3.10) remained significantly associated, while smoking, diabetes, hyperlipidaemia, estimated glomerular filtration rate and serum calcium were not.
Conclusions AVC was prevalent in the general population of men aged 60–74 years and was significantly associated with all modifiable cardiovascular risk factors, but only selectively after adjustment for CAC ≥400 AU.
- coronary angiography
- coronary artery disease
- risk factors
- diagnostic imaging
- heart valve diseases
Data availability statement
Data are available on reasonable request. Study data were collected and managed using REDCap data management, hosted at the Odense Patient data Explorative Network.
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Correction notice This article has been corrected since it was first published online. Author name 'Martin Buske' has been corrected to 'Martin Busk'.
Contributors Writing: LK, JEM, ACPD. Statistical analysis, table and figures: LK. CT scans: description, quality control and inter-intra observer variability test: MHF, GU, MK, MB, FHS, JL. Project: idea, planning and coordination: ACPD, JSL, KE, JL, LF, FHS. All authors have contributed to the content of the final version of the manuscript.
Funding The first author has received funding from the University of Southern Denmark and from the Region of Southern Denmark.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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