Aortic Arch Calcification Associated with Cardiovascular Events and Death among Patients with Acute Coronary Syndrome.

BACKGROUND

To date, it remains unsettled whether aortic arch calcification (AAC) has prognostic value in patients with acute coronary syndrome.

METHODS

From January 1 to December 31, 2013, a total of 225 patients with acute coronary syndrome (mean age 72 ± 26 years, 75% male) were enrolled in this study. Patients admitted to the coronary care unit of a tertiary referral medical center under the preliminary diagnosis of acute coronary syndrome were retrospectively investigated. The primary endpoint was composite of long-term major adverse cardiovascular events. The secondary endpoints were 30-day and long-term all-cause mortality.

RESULTS

Of the 225 patients enrolled in this study, 143 had detectable AAC. Those who had AAC were older, with higher Killip classification and thrombolysis in myocardial infarction (TIMI) score with a lower probability of single vessel disease. Acute coronary syndrome patients with AAC had significantly higher 30-day mortality (17.3% vs. 7.1%, log-rank p = 0.02). During a mean follow-up period of 165 ± 140 days (maximum 492 days), the calcification group had significantly increased cardiovascular deaths (27.6% vs. 11.2%, log-rank p = 0.002), all-cause mortality (28.3% vs. 11.2%, log-rank p = 0.001) and composite endpoint of major adverse cardiovascular events (39.4% vs. 24.6%, log-rank p = 0.01). After adjusting for age, gender, diabetes mellitus and hypertension, AAC was an independent risk factor for primary and secondary endpoints among patients with acute coronary syndrome.

CONCLUSIONS

AAC provided valuable prognostic information on clinical outcomes in patients with acute coronary syndrome. However, different treatment strategies would be warranted for optimal risk reduction in such a population.