Aortic valve calcification - Determinants and progression in the population

Background - Aortic valve calcification (AVC) is considered degenerative. Recent data suggested links to atherosclerosis or coronary disease ( CAD). Methods and Results - AVC and coronary artery calcifications (CAC) were prospectively assessed by Electron-Beam-Computed- Tomography in 262 population-based research participants >= 60 years. AVC was frequent (27%) with aging (P < 0.01) and in men (P < 0.05). AVC was associated with diabetes, hypertension, higher body-mass-index, and serum glucose (all P < 0.05). AVC was a marker of higher prevalence (P < 0.01) and severity of CAD (CAC score: 441 +/- 802 versus 265 +/- 566, P < 0.05) independently of age. After follow-up of 3.8 +/- 0.9 years, AVC score increased (94 +/- 271 versus 54 +/- 173, P < 0.01, +11 +/- 32 U/year), faster with higher baseline AVC score (P < 0.01). Compared with participants remaining free of AVC, de novo acquisition of AVC was associated with higher LDL-cholesterol (141 +/- 31 versus 121 +/- 27 mg/dL, P < 0.05) and faster CAC progression (+78 +/- 87 versus +28 +/- 47 U/year, P < 0.05). In multivariate analysis, LDL-cholesterol independently determined AVC acquisition while higher baseline AVC scores determined faster progression of existing AVC. Conclusion - In the population, AVC is frequent with aging and atherosclerotic risk factors. AVC is a marker of subclinical CAD. AVC is progressive, appearing de novo with progressive atherosclerosis whereas established AVC progresses independently of atherosclerotic risk factors and faster with increasing initial AVC loads.