TY - JOUR
T1 - Intimal and medial calcification in relation to cardiovascular risk factors
AU - Zwakenberg, Sabine R.
AU - de Jong, Pim A.
AU - Hendriks, Eva J.
AU - Westerink, Jan
AU - Spiering, Wilko
AU - de Borst, Gert J.
AU - Cramer, Maarten J.
AU - Bartstra, Jonas W.
AU - Doesburg, Teddo
AU - Rutters, Femke
AU - van der Heijden, Amber A.
AU - Schalkwijk, Casper
AU - Schurgers, Leon J.
AU - van der Schouw, Yvonne T.
AU - Beulens, Joline W. J.
AU - SMART Study Grp
N1 - Funding Information:
J.W.J. Beulens and S.R. Zwakenberg are supported by the Senior Dr. Dekker grant (2013T120) from the Dutch Heart Foundation.
Publisher Copyright:
© 2020 Zwakenberg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2020/7/13
Y1 - 2020/7/13
N2 - Purpose To assess specific risk factors and biomarkers associated with intimal arterial calcification (IAC) and medial arterial calcification (MAC). Methods We conducted a cross-sectional study in patients with or at risk of vascular disease from the SMART study(n = 520) and the DCS cohort(n = 198). Non-contrast computed tomography scanning of the lower extremities was performed and calcification in the femoral and crural arteries was scored as absent, predominant IAC, predominant MAC or indistinguishable. Multinomial regression models were used to assess the associations between cardiovascular risk factors and calcification patterns. Biomarkers for inflammation, calcification and vitamin K status were measured in a subset of patients with IAC(n = 151) and MAC(n = 151). Results Femoral calcification was found in 77% of the participants, of whom 38% had IAC, 28% had MAC and 11% were scored as indistinguishable. The absolute agreement between the femoral and crural arteries was high(69%). Higher age, male sex, statin use and history of coronary artery disease were associated with higher prevalences of femoral IAC and MAC compared to absence of calcification. Smoking and low ankle-brachial-index (ABI) were associated with higher prevalence of IAC and high ABI was associated with less IAC. Compared to patients with IAC, patients with MAC more often had diabetes, have a high ABI and were less often smokers. Inactive Matrix-Gla Protein was associated with increased MAC prevalence, while osteonectin was associated with decreased risk of MAC, compared to IAC. Conclusions When femoral calcification is present, the majority of the patients have IAC or MAC throughout the lower extremity, which have different associated risk factor profiles.
AB - Purpose To assess specific risk factors and biomarkers associated with intimal arterial calcification (IAC) and medial arterial calcification (MAC). Methods We conducted a cross-sectional study in patients with or at risk of vascular disease from the SMART study(n = 520) and the DCS cohort(n = 198). Non-contrast computed tomography scanning of the lower extremities was performed and calcification in the femoral and crural arteries was scored as absent, predominant IAC, predominant MAC or indistinguishable. Multinomial regression models were used to assess the associations between cardiovascular risk factors and calcification patterns. Biomarkers for inflammation, calcification and vitamin K status were measured in a subset of patients with IAC(n = 151) and MAC(n = 151). Results Femoral calcification was found in 77% of the participants, of whom 38% had IAC, 28% had MAC and 11% were scored as indistinguishable. The absolute agreement between the femoral and crural arteries was high(69%). Higher age, male sex, statin use and history of coronary artery disease were associated with higher prevalences of femoral IAC and MAC compared to absence of calcification. Smoking and low ankle-brachial-index (ABI) were associated with higher prevalence of IAC and high ABI was associated with less IAC. Compared to patients with IAC, patients with MAC more often had diabetes, have a high ABI and were less often smokers. Inactive Matrix-Gla Protein was associated with increased MAC prevalence, while osteonectin was associated with decreased risk of MAC, compared to IAC. Conclusions When femoral calcification is present, the majority of the patients have IAC or MAC throughout the lower extremity, which have different associated risk factor profiles.
KW - MATRIX GLA-PROTEIN
KW - ARTERY CALCIFICATION
KW - VASCULAR CALCIFICATION
KW - DISEASE
KW - ASSOCIATION
KW - COMPLICATIONS
KW - MORTALITY
U2 - 10.1371/journal.pone.0235228
DO - 10.1371/journal.pone.0235228
M3 - Article
C2 - 32658909
SN - 1932-6203
VL - 15
JO - PLOS ONE
JF - PLOS ONE
IS - 7
M1 - 0235228
ER -