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Prognostic Application of Thoracic Aortic Calcium Scoring for Adverse Clinical Outcome Risk in Elderly Patients with Left Ventricular Hypertrophy

Authors
 In-Jeong Cho  ;  Hyuk-Jae Chang  ;  Sang-Eun Lee  ;  Chi Young Shim  ;  Geu-Ru Hong  ;  Namsik Chung 
Citation
 Korean Circulation Journal, Vol.47(6) : 918-928, 2017 
Journal Title
 Korean Circulation Journal 
ISSN
 1738-5520 
Issue Date
2017
Keywords
Left ventricular hypertrophy ; Prognosis ; Vascular calcification
Abstract
BACKGROUND AND OBJECTIVES: Left ventricular hypertrophy (LVH) is associated with poor cardiovascular outcomes. Heavy aortic calcification exacerbates arterial stiffness, which consequently heightens left ventricular (LV) afterload. We assessed the usefulness of aortic calcification for predicting adverse cardiovascular outcomes and to determine whether the relationship, if any, differed as a function of LVH. METHODS: The analytic sample was comprised of a total of 487 individuals 65 years of age or older. Thoracic aorta calcium score (TACS) was measured by coronary computed tomography, and patients were stratified according to the median (TACS, 446 mm³). LVH obtained from echocardiography was defined as LV mass index >115 g/m² for men and >95 g/m² for women. Cox regression reporting hazard ratios (HRs) with 95% confidence intervals (CIs) was performed to predict the risk for the composite study endpoint, defined as cardiac death, admission for heart failure, obstructive coronary artery disease (CAD) requiring revascularization, or stroke. RESULTS: A total of 39 composite events (8.0%) occurred during a median follow-up of 65 months (interquartile range [IQR], 17-89 months). For those with LVH, the concurrent presence of high TACS appeared to be an independent predictor (HR, 4.51; 95% CI, 1.71-11.88; p=0.002) for the composite study endpoint. Other combined LVH and TACS subgroups were not associated with significant factors for predicting the composite study endpoint (p>0.050, all). CONCLUSION: TACS provides robust predictive utility for a composite of cardiovascular events and cardiac death in persons with LVH. This finding was less pronounced in those with a relatively healthy myocardium, defined by the absence of LVH.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161502
DOI
10.4070/kcj.2016.0443
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
심지영(Shim, Chi Young)
장혁재(Chang, Hyuck Jae)
정남식(Chung, Nam Sik)
조인정(Cho, In Jeong)
홍그루(Hong, Geu Ru)
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