The interdependence between cardiovascular calcifications in different arterial beds and vascular risk factors in patients at high cardiovascular risk

Objective: The objective was to explore the interdependence between cardiovascular risk factors and cardiovascular calcifications on the cardiac valves and in multiple vascular beds in the chest and abdomen in a high-risk population. Methods: 276 participants of the SMART study who received a CT scan of the chest and abdominal region within one year were evaluated for the presence of cardiovascular calcifications throughout the body. Cardiovascular calcifications were manually scored in the coronary arteries, the aorta, the supra aortic vessels, the infra aortic vessels, the aortic valve, the renal arteries and the splenic artery. The following clinical risk factors of cardiovascular disease were included in principal component analysis, body mass index, systolic blood pressure, glucose, total cholesterol and carotid intima media thickness (cIMT) as a marker of atherosclerosis. Results: Principal component analysis yielded three uncorrelated components. The first consisted of cardiovascular calcifications and cIMT (variance = 35.4%), the second contained BMI and glucose (variance = 11.1%), and the third component consisted of systolic blood pressure and cholesterol (variance = 9.0%). Combined these three components explained 56% of the total variance within the dataset. Strong associations were observed among vascular calcifications and cIMT, whereas the association between clinical risk factors and cardiovascular calcifications was weak. Conclusion: The results suggest a single systemic nature of cardiovascular calcifications throughout the body that do not cluster with traditional cardiovascular risk factors.