Clinical InvestigationAcute Ischemic Heart DiseaseClinical significance of calcification of the fibrous skeleton of the heart and aortosclerosis in community dwelling elderly. The Cardiovascular Health Study (CHS)
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Participant population
The CHS is an observational cohort study designed to assess risk factors and cardiovascular disease outcomes in elderly persons. Participants aged ≥65 were sampled from Medicare enrollment lists in 4 US communities. Of 5888 participants (age, 65-100 at study entry) enrolled in the study, 5201 were recruited in 1989 to 1990, and a supplemental cohort of 687 African-American participants were added in 1992 to 1993. Persons were excluded from the CHS if they were wheel-chair bound or
Characteristics of the subjects and prevalence of valvular calcification
The mean age of the participants was 76 ± 5 years, 60% were women, 83.4% were white, 16.2% were African American, and 0.5% were recorded as “other” race. Mitral annular calcification was found in 1640 (42%) participants, AAC in 1710 (44%), AVS in 2114 (54%), and all 3 were present together in 662 participants (17%). Combined MAC and AAC were found in 25% of participants, MAC and AVS in 26%, and AAC combined with AVS in 28% of the subjects (Figure 1). Participants with MAC or AAC and/or AVS were
Discussion
In this large cohort of free-living elderly individuals, MAC, AAC, AVS, and their combination were highly prevalent and associated with advancing age as well as with CVD independently of age and sex. However, the strength of association between these 3 forms of ectopic valvular calcification with CVD varied, MAC having the strongest relationship with CVD.
The high prevalence of calcified mitral annulus and AVS, and their relationship to age in the present study are consistent with prior clinical
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Supported by NHLBI contracts NO1-HC-85079-85086 and NO1-HC-15103.