Abdominal aortic calcification is a risk factor for atherosclerotic vascular disease in elderly women — ASN Events
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Abdominal aortic calcification is a risk factor for atherosclerotic vascular disease in elderly women (#75)

Joshua R Lewis 1 2 , John T Schousboe 3 , Wai H Lim 4 , Germaine Wong 1 , Kevin E Wilson 5 , Kun Zhu 6 7 , Peter L Thompson 8 , Douglas P Kiel 9 , Richard L Prince 6 10
  1. Centre for Kidney Research, School of Public Health, School of Medicine, University of Sydney, Sydney, NSW, Australia
  2. University of Sydney, Westmead, NSW, Australia
  3. Division of Health Policy and Management, University of Minnesota, Minneapolis, USA
  4. Renal Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
  5. Skeletal Health, Hologic Inc, Bedford, MA, USA
  6. School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit , University of Western Australia, Perth
  7. Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital , Perth
  8. Cardiology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
  9. Institute for Aging Research, Hebrew Senior Life, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
  10. Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia

Bone densitometers can quickly and easily capture lateral spine images, primarily for vertebral fracture assessment. Abdominal aortic calcification (AAC) is commonly seen on these images and has been promoted as a risk factor for atherosclerotic vascular disease (ASVD) however there is uncertainty about its value in elderly women routinely undergoing bone densitometry. We investigated whether AAC was associated with long-term ASVD hospitalisations and deaths in 1,052 community-dwelling ambulant elderly women over 70 years. AAC24 scores were calculated from digital single-energy lateral spine images from a scanning densitometer in 1998 or 1999. Of the 1052 women there were 471 (45%) that had low AAC (AAC24 score 0 or 1), 387 (37%) that had moderate AAC (AAC24 score 2-5) and 197 (19%) that had severe AAC (AAC24 score >5). Over 14.5 years, 420 women experienced an ASVD hospitalisation or death (265 ASVD-related deaths). Increasing severity of AAC was associated with increased absolute risk of ASVD hospitalisation or death (low=37%, moderate=39% and severe=49%, P=0.008 for trend) and ASVD deaths (low=15%, moderate=21% and severe=27%, P<0.001 for trend). After adjusting for Framingham general cardiovascular risk scores, women with severe AAC had increased hazard for ASVD hospitalizations or death, Hazard ratio (HR) 1.37, 95% CI 1.07-1.77, P=0.013, while women with moderate and severe AAC had increased hazard for ASVD-related deaths HR 1.41, 95% CI 1.03-1.94, P=0.034 and HR 1.80, 95% CI 1.26-2.57, P=0.001 respectively. In conclusion, abdominal aortic calcification calculated on images obtained from a bone densitometer are associated with a greater risk of long-term ASVD hospitalizations and deaths independent of conventional risk factors. Given the test can be conveniently captured during bone density the assessment AAC may be a promising tool to inform primary prevention strategies in elderly women.