Kim Hyung-Kwan, Park Seung-Jung, Suh Jung-Won, Kim Yong-Jin, Kim Hyo-Soo, Sohn Dae-Won, Oh Byung-Hee, Lee Myoung-Mook, Park Young-Bae, Choi Yun-Shik
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Coron Artery Dis. 2004 Feb;15(1):1-6. doi: 10.1097/00019501-200402000-00001.
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.
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).
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 > or = 2 cRF was 12.3 compared to the < or = 1 cRF group without MVSC.
MAC and AVSC were independently associated with CAD in a low-risk Korean population. Also, combination of MVSC with > or = 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 > or = 2 cRF.
二尖瓣环钙化（MAC）或主动脉瓣硬化钙化（AVSC）在老年人中常见，且在白种人中与冠状动脉疾病（CAD）相关。本研究旨在确定MAC或AVSC在韩国人中是否也与CAD相关，并具有预测CAD的能力，如同在白种人中一样。
纳入308例因胸痛接受冠状动脉造影和经胸超声心动图检查的患者（189例男性；平均年龄60.5±9.8岁）。
与CAD（-）组相比，CAD（+）组中MAC和AVSC的患病率显著更高（分别为83.9%:55.2%，87.9%:57.5%，均p<0.001）。在对MAC和AVSC以及传统冠状动脉危险因素（cRF）进行多因素分析时，MAC、男性性别、AVSC和糖尿病与CAD显著相关（分别为p<0.001、<0.001、0.010和0.014）。此外，MAC和AVSC的患病率与由狭窄冠状动脉数量定义的CAD严重程度之间存在正线性关系（均p<0.001）。此外，与无MVSC的≤1个cRF组相比，具有多个瓣膜硬化钙化（MVSC）且≥2个cRF组的CAD比值比为12.3。
在低风险的韩国人群中，MAC和AVSC与CAD独立相关。此外，MVSC与≥2个cRF的组合增加了CAD存在的预测性。因此，在经胸超声心动图中检测到MVSC且患者有≥2个cRF时，必须考虑CAD的可能性。
