We assessed the association of mitral annular calcification (MAC) with atherosclerotic risk factors and severity and complexity of coronary artery disease (CAD). Cardiac catheterization reports and electronic medical records from 2010 to 2011 were retrospectively reviewed. A total of 481 patients were divided into 2 groups: MAC present (209) and MAC absent (272). All major cardiovascular risk factors, comorbidities, and coronary lesion characteristics were included. On linear regression analysis, age (P = .001, β 1.12) and female gender (P = .031, β 0.50) were the independent predictors of MAC. Mitral annular calcification was not independently associated with the presence of lesions with >70% stenosis (P = .283), number of obstructive vessels (P = .469), lesions with 50% to 70% stenosis (P = .458), and Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery score (P = .479). Mitral annular calcification is probably a benign marker of age-related degenerative changes in the heart independent of the severity and complexity of CAD.
JassalDTamJBhagirathK. Association of mitral annular calcification and aortic valve morphology: a sub-study of the aortic stenosis progression observation measuring effects of rosuvastatin (ASTRONOMER) study. Eur Heart J. 2008;29
(12):1542–1547.
2.
MovahedMSaitoYKashaniMRaminE. Mitral annulus calcification is associated with valvular and cardiac structural abnormalities. Cardiovasc Ultrasound. 2007;5:14.
3.
SgorbiniLScuteriALeggioMLeggioF. Association of mitral annulus calcification, aortic valve calcification with carotid intima media thickness. Cardiovasc Ultrasound. 2004;2:19.
4.
QasimARafeeqHRasaniaS. Cardiovascular risk factors and mitral annular calcification in type 2 diabetes. Atheroscleroris. 2013;226
(2):419–424.
5.
KanjanauthaiSNasirKKatzR. Relationships of mitral annular calcification to cardiovascular risk factors: the multi-ethnic study of atherosclerosis (MESA). Atherosclerosis. 2010;213
(2):558–562.
6.
BoonACheriexELodderJKesselsF. Cardiac valve calcification: characteristics of patients with calcification of mitral annulus or aortic valve. Heart. 1997;78
(5):472–474.
7.
AllisonMCheungPCriguiMLangerRDWrightCM. Mitral and aortic annular calcification are highly associated with systemic calcified atherosclerosis. Circulation. 2006;113
(6):861–866.
8.
SavageDGarrisonJCastelliP. Prevalence of submitral (annular) calcium and its correlates in a general population based sample (the Framingham study). Am J Cardiol. 1983;51
(8):1375–1378.
9.
ShurmurWD’EliaAGleasonENestoRWDeSilvaRAWeinrauchLA. Cardiac conduction defects associated with aortic and mitral valve calcification in dialysis patients. Ren Fail. 1990;12
(2):103–107.
10.
Jeren-strujicBRaosVJerenTHorvatin-GodlerS. Comparative study of mitral annular calcification (MAC) with cardiac arrhythmias in dialysis patients. Coll Antropol. 1997;21
(1):167–174.
11.
RafeekHRasaniaSChurchillT. Quantitative assessment of mitral annular calcification by cardiac CT in a diabetic population: association with cardiovascular risk factors and coronary artery calcium. J Am Col Cardiol. 2012:59
(13):E1194.
12.
TenenbaumAShemeshJFismanEMotroM. Advanced mitral annular calcification is associated with severe coronary calcification on fast dual spiral computed tomography. Invest Radiol. 2000;35
(3):193–198.
13.
AtarSJeonDLuoHSiegelRJ. Mitral annular calcification: a marker of severe coronary artery disease in patients under 65 years old. Heart. 2003;89
(2):161–164.
14.
AdlerYHerzIVaturiM. Mitral annular calcification detected by transthoracic echocardiography is a marker for high prevalence and severity of coronary artery disease in patients undergoing coronary angiography. Am J Cardiol. 1998;82(10):1183–1186.
15.
SianosGMorelMAKappeteinAP. The SYNTAX score: an angiographic tool grading the complexity of coronary artery disease. Eurointervention. 2005;1
(2):219–227.
16.
CapodannoDCapranzanoPDi SalvoM. Usefulness of SYNTAX score to select patients with left main coronary artery disease to be treated with coronary artery bypass graft. JACC Cardiovasc Interv. 2009;2(8):731–738.
17.
HeadSFarooqVSerruysP. The SYNTAX score and its clinical implications. Heart. 2014;100
(2):169–177.
18.
GirasisCGargSRaberL. SYNTAX score and clinical SYNTAX score as predictors of very long-term clinical outcomes in patients undergoing percutaneous coronary interventions: a sub-study of sirolimus-eluting stent compared with paclitexal-eluting stent for coronary revascularization (SIRTAX) trial. Eur Heart J. 2011;32
(24):3115–3127.
19.
TanakaTSetoSYamamotoKKondoMOtomoT. An assessment of risk factors for the complexity of coronary artery disease using the SYNTAX score. Cardiovasc Interv Ther. 2013;28(1):16–21.
20.
YanQGuoJZhangCGaoW. The relationship between kidney function and angiographically derived SYNTAX score. Can J Cardiol. 2011;27
(6):768–772.
21.
NairCSudhakaranCAronowWThomsonWWoodruffMPSketchMH. Clinical characteristics of patients younger than 60 years with mitral annular calcium: comparison with age and sex matched control subjects. Am J Cardiol. 1985;54
(10):1286–1287.
22.
RamarajRManriqueCHashemzadehMMovahedMR. Mitral annulus calcification is independently associated with all-cause mortality. Exp Clin Cardiol. 2013;18
(1):e5–e7.
23.
AdlerYKorenAFinkN. Association between mitral annulus calcification and carotid atherosclerotic disease. Stroke. 1998;29(9):1833–1837.
IxJChertowGShlipakMBrandenburgVMKettelerMWhooleyMA. Association of fetuin-a with mitral annular calcification and aortic stenosis among persons with coronary heart disease: data from the heart and soul study. Circulation. 2007;115
(19):2533–2539.
26.
MaherRYoungGSmyth-WalshB. Aortic and mitral valve calcification in patients with end-stage renal disease. Lancet. 1987;2
(8564):875–877.
27.
RaosVJeren-StrujicBAntosMHorvatin-GodlerS. Frequency of mitral annular calcification in patients on hemodialysis estimated by 2-dimensional echocardiography. Acta Med Croatica. 1996;50
(4):179–183.
28.
RitschardTBlumbergAJenzerR. Mitral annular calcification in dialysis patients. Schweiz Med Wochenschr. 1987;117
(37):1363–1367.
29.
RibeiroSRamosABrandaoA. Cardiac valve calcification in hemodialysis patients: role of calcium phosphate metabolism. Nephrol Dial Transplant. 1998;13
(8):2037–2040.
30.
BurkeAKolodgieFVirmaniR. Fetuin-A, valve calcification and diabetes: what do we understand. Circulation. 2007;115
(19):2464–2467.
31.
DavutogluVYilmazMSoydincS. Mitral annular calcification is associated with osteoporosis in women. Am Heart J. 2004;147
(6):1113–1116.
32.
NishideMIrinoTGotohMNakaMTsujiK. Cardiac abnormalities in ischemic cerebrovascular disease studies by two dimensional echocardiography. Stroke. 1983;14
(4):541–545.
33.
AdlerYKorenAFinkN. Association between mitral annulus calcification and carotid atherosclerotic disease. Stroke. 1998;29
(9):1833–1837.
34.
BenjaminEPlehnJD’AgostinoR. Mitral annular calcification and the risk of stroke in an elderly cohort. N Engl J Med. 1992;327
(6):374–379.
35.
De MarcoMGerdtsECasalnuovoG. Mitral annular calcification and incident ischemic stroke in treated hypertensive patients: the LIFE study. Am J Hypertens. 2013;26
(4):567–573.
36.
AdlerYLevingerUKorenA. Association between mitral annulus calcification and peripheral arterial atherosclerotic disease. Angiology. 2000;51
(8):639–646.
37.
AdlerYFinkNSpectorDWiserISagieA. Mitral annulus calcification: a window to diffuse atherosclerosis of the vascular system. Atherosclerosis. 2001;155
(1):1–8.
38.
NemcsikJFarkasKKolossvaryE. Intracardiac calcification is a marker of generalized atherosclerosis. Angiology. 2007;58
(4):413–419.
39.
KamenskyGLisyLPolakEPiknovaEPlevovaN. Mitral annular calcifications and aortic plaques as predictors of increased cardiovascular mortality. J Cardiol. 2001;37 suppl 1:21–26.
40.
JeonSAtarSBraschV. Association of mitral annulus calcification, aortic valve sclerosis and aortic root calcification with abnormal myocardial perfusion single photon emission tomography in subjects age < or =65 years old. J Am Coll Cardiol. 2001;38
(7):1988–1993.
41.
RossiATargherGZoppiniG. Aortic and mitral annular calcifications are predictive of all-cause and cardiovascular mortality in patients with type 2 diabetes mellitus. Diabetes Care. 2005;35
(8):1781–1786.
42.
UtsunomiyaHYamamotoHKunitaE. Combined presence of aortic valve calcification and mitral annular calcification as a marker of the extent and vulnerable characteristics of coronary artery plaque assessed by 64-multidetector computed tomography. Atherosclerosis. 2010;213
(1):166–172.
43.
FreemanROttoC. Spectrum of calcific aortic valve disease: pathogenesis, disease progression and treatment strategies. Circulation. 2005;111
(24):3316–3326.
44.
PachonMZamoranoJ. Mitral annular calcifications and aortic valve stenosis. Eur Heart J. 2008;29
(12):1478–1480.
45.
AronowWAhnCKronzonIGoldmanME. Association of coronary risk factors and use of statins with progression of mild valvular aortic stenosis in older persons. Am J Cardiol. 2001;88
(6):693–695.
46.
PohleKMaffertRRopersD. Progression of aortic valve calcification: association with coronary atherosclerosis and cardiovascular risk factors. Circulation. 2001;104
(16):1927–1932.
47.
RosenhekRRaderFLohoN. Statins but not angiotensin-converting enzyme inhibitors delays progression of aortic stenosis. Circulation. 2004;110
(10):1291–1295.
48.
ChanLTeoKDumensilGNiATamJ; ASTRONOMER Investigators. Effect of lipid lowering with rosuvastatin on progression of aortic stenosis: results of the aortic stenosis progression observation: measuring effects of rosuvastatin (ASTRONOMER) trial. Circulation. 2010;121
(2):306–314.
49.
RosseboAPedersonTBomanK. Intensive lipid lowering with simvastatin and ezetimibe in aortic stenosis. N Engl J Med. 2008;359
(13):1343–1356.
50.
KamathAPaiR. Risk factors for progression of calcific aortic stenosis and potential therapeutic targets. Int J Angiol. 2008;17
(2):63–70.
51.
MasonA. Angiotensin-converting enzymes inhibitors and renal function. Ann Pharmacother. 1990;24(5):496–505.
52.
RuggenentiPPernaARemuzziG. ACE inhibitors to prevent end-stage renal disease: when to start and why possibly never to stop: a post hoc analysis of the rein trial results. J Am Soc Nephrol. 2001;12(12):2832–2837.
53.
SandhuSWiebeNFriedFTonelliM. Statins for improving renal outcomes: a meta-analysis. J Am Soc Nephrol. 2006;17(7):2006–2016.
