Distribution, size, and shape of abdominal aortic calcified deposits and their relationship to mortality in postmenopausal women

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Abdominal aortic calcifications (AACs) correlate strongly with coronary artery calcifications and can be predictors of cardiovascular
mortality.We investigated whether size, shape, and distribution of AACs are related to mortality and how such prognostic
markers perform compared to the state-of-the-art AC24 marker introduced by Kauppila. Methods. For 308 postmenopausal
women, we quantified the number of AAC and the percentage of the abdominal aorta that the lesions occupied in terms of their
area, simulated plaque area, thickness, wall coverage, and length. We analysed inter-/intraobserver reproducibility and predictive
ability of mortality after 8-9 years via Cox regression leading to hazard ratios (HRs). Results. The coefficient of variation was below
25% for all markers. The strongest individual predictors were the number of calcifications (HR = 2.4) and the simulated area
percentage (HR = 2.96) of a calcified plaque, and, unlike AC24 (HR = 1.66), they allowed mortality prediction also after adjusting
for traditional risk factors. In a combined Cox regression model, the strongest complementary predictors were the number of
calcifications (HR = 2.76) and the area percentage (HR = -3.84). Conclusion. Morphometric markers of AAC quantified from
radiographs may be a useful tool for screening and monitoring risk of CVD mortality.
Original languageEnglish
Article number459286
JournalInternational Journal of Biomedical Imaging
Number of pages8
Publication statusPublished - 2012

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