Association between cardiac valvular calcification and coronary artery diseae in a low-risk population

Background: Mitral annulus calcification (MAC) or aortic valve sclerocalcification (AVSC) is common with aging and associated with coronary artery disease (CAD) in Caucasians. This study was performed to determine whether MAC or AVSC is also associated with, and has a power to predict, CAD in Koreans as in Caucasians. Methods: Three hundred and eight patients with chest pain, who had undergone coronary angiography and transthoracic echocardiography, were enrolled (189 males; mean 60.5 ± 9.8 years). Results: The prevalence of MAC and AVSC was significantly more common in CAD (+) compared with CAD (-) group (83.9%:55.2%, 87.9%:57.5%, respectively, both p < 0.001). On multivariate analysis with MAC and AVSC along with conventional coronary risk factors (cRF), MAC, male gender, AVSC, and diabetes mellitus were significantly associated with CAD (p < 0.001, < 0.001, 0.010 and 0.014 respectively). Additionally, a positive linear relationship was found between the prevalence of both MAC and AVSC and the extent of CAD defined by the number of stenotic coronary arteries (both p < 0.001). Furthermore, the odds ratio for CAD in the group with both multiple valvular sclerocalcification (MVSC) and ≥ 2 cRF was 12.3 compared to the ≤ 1 cRF group without MVSC. Conclusions: MAC and AVSC were independently associated with CAD in a low-risk Korean population. Also, combination of MVSC with ≥ 2 cRF increased the predictability of the presence of CAD. Therefore, the possibilities of CAD must be considered when MVSC is detected in transthoracic echocardiography in patients with ≥ 2 cRF.