Moradi Maryam, Jahromi Amirabbas Shafiei
Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2024 Jan 30;29:3. doi: 10.4103/jrms.jrms_53_23. eCollection 2024.
There is a lack of evidence on the link between mitral annular calcification (MAC) and coronary atherosclerotic diseases. The present investigation was undertaken to detect the clinical and prognostic value of MAC in coronary atherosclerotic diseases in patients who underwent coronary computed tomographic (CT) angiography.
Two hundred and five individuals with MAC and without it ( = 85 and 120, respectively) were included in the present cross-sectional study. Coronary artery disease-reporting and data system (CAD-RADS) at coronary CT angiography was used to define the severity of coronary atherosclerotic diseases. Patients were classified into no or non-significant CAD (CAD-RADS 0-2) and significant CAD (CAD-RADS 3-5) according to the severity of coronary atherosclerotic diseases. The association of MAC with two mentioned groups (no or non-significant CAD and significant CAD) was assessed using the Chi-squared test and logistic regression in crude and adjusted models.
Patients with MAC were significantly older (69.34 ± 8.20 vs. 60.64 ± 11.42, < 0.001), had lower glomerular infiltration rate (69.67 ± 20.92 vs. 78.00 ± 20.23, = 0.005), and higher coronary artery calcification score (352.87 ± 495.85 vs. 200.55 ± 426.13, = 0.05) in comparison to those without MAC. However, the significant difference between the two groups regarding coronary artery calcification score disappeared after adjustment for confounders ( = 0.14). In addition, a statistically significant positive link between MAC and significant CAD was observed (odds ratio [OR] [95% confidence interval (CI)]: 1.96 [1.04-3.71], = 0.04). Nevertheless, the association became statistically insignificant after adjustment for confounders (OR [95% CI]: 1.60 [0.78-3.28], = 0.2).
The findings of the study revealed that MAC has no independent prognostic value in coronary atherosclerotic diseases evaluated by coronary CT angiography.
二尖瓣环钙化（MAC）与冠状动脉粥样硬化性疾病之间的联系缺乏证据。本研究旨在检测MAC在接受冠状动脉计算机断层扫描（CT）血管造影的患者的冠状动脉粥样硬化性疾病中的临床和预后价值。
本横断面研究纳入了205例有或无MAC的个体（分别为85例和120例）。冠状动脉CT血管造影的冠状动脉疾病报告和数据系统（CAD-RADS）用于定义冠状动脉粥样硬化性疾病的严重程度。根据冠状动脉粥样硬化性疾病的严重程度，患者被分为无或非显著性冠状动脉疾病（CAD-RADS 0-2）和显著性冠状动脉疾病（CAD-RADS 3-5）。在粗模型和校正模型中，使用卡方检验和逻辑回归评估MAC与上述两组（无或非显著性冠状动脉疾病和显著性冠状动脉疾病）的关联。
与无MAC的患者相比，有MAC的患者年龄显著更大（69.34±8.20对60.64±11.42，P<0.001），肾小球滤过率更低（69.67±20.92对78.00±20.23，P=0.005），冠状动脉钙化评分更高（352.87±495.85对200.55±426.13，P=0.05）。然而，在对混杂因素进行校正后，两组之间冠状动脉钙化评分的显著差异消失（P=0.14）。此外，观察到MAC与显著性冠状动脉疾病之间存在统计学上显著的正相关（优势比[OR][95%置信区间（CI）]：1.96[1.04-3.71]，P=0.04）。然而，在对混杂因素进行校正后，该关联变得无统计学意义（OR[95%CI]：1.60[0.78-3.28]，P=0.2）。
该研究结果表明，在通过冠状动脉CT血管造影评估的冠状动脉粥样硬化性疾病中，MAC没有独立的预后价值。
