Relation of nonobstructive aortic valve calcium to carotid arterial atherosclerosis

Recently it was shown that subjects with aortic valve calcium (AVC) are at increased risk for future cardiovascular disease including stroke. We hypot hesized that the increased risk of stroke may be due to an association with carotid artery atherosclerotic disease. Between 1995 and 1999 our laborato ry made a diagnosis of AVC without significant stenosis in 3,949 patients. Of those, 279 patients without other cardiac structural exclusion criteria (148 men and 131 women; mean age 73 +/- 9 years, range 45 to 90) underwent carotid artery duplex ultrasound for various indications, and formed the st udy group. Age- and sex-matched patients without ave (n = 277), who underwe nt carotid artery duplex ultrasound during the some period and for the same indications, served as the control group. Compared with the control group, the AVC group had a significantly higher prevalence of carotid stenosis (> 40% to 60%, 89% vs 78% [p <0.001]; > 60% to 80%, 43% vs 23% [p <0.001]; and > 80% to 100%, 32% vs 14% [p <0.001 ]). The AVC group had a similar, signi ficantly higher prevalence of <greater than or equal to>2-vessel disease an d bilateral carotid stenosis (stenosis levels of >20% to 40%, >40% to 60%, >60% to 80%, and >80% to 100%). In multivariate analysis, AVC, but not trad itional risk factors, was the only independent predictor of severe carotid atherosclerotic disease (stenosis >80% to 100%; p = 0.0001). Thus, there is a significant association between the presence of AVC and carotid atherosc lerotic disease. (C) 2000 by Excerpta Medica, Inc.