MITRAL ANNULAR CALCIFICATION IN ELDERLY PATIENTS: RELATIONSHIP WITH CLINICAL MANIFESTATIONS AND RISK FACTORS OF CARDIOVASCULAR DISEASES CAUSED BY ATHEROSCLEROSIS

The aim – to study the association of the mitral annular calcification (MAC) with traditional risk factors and clinical manifestations of atherosclerosis
in patients aged over 65 years without diabetes.

Materials and methods. The prospective study included 100 patients over 65 years with MAC consistently identified among 910 ambulatory patients after transthoracic Doppler echocardiography in relation to the symptoms of cardiovascular disease. The comparison group consisted of 65 consecutively examined patients aged over 65 with no MAC.

Results. When comparing risk factors in patients with and without MAC, MAC statistically significant differences was found with age (72,4 ± 5,4 and 70,2 ± 4,3 years, respectively; p = 0,006), the incidence of hypertension of moderate and severe degree (99 % and 90.8 % of patients, p = 0.012), levels of total cholesterol – TC (6,91 ± 0,92 and 6,2 ± 0,90 mmol / l, p = 0.0008) and lipoproteinlow density (3,57 ± 0,95 and 2,96 ± 0,96 mmol / l, p = 0.004) in subgroups of patients aged 65 to 70 years. In multivariate analysis remained statistically significant association of MAC only with age (p = 0,025, β = 0,173) and total cholesterol levels (p = 0,040; β = 0,160). Averages of the coefficient of atherogenicity of blood lipids, systolic and diastolic blood pressure, C-reactive protein, body mass index, waist circumference, the frequency of smoking, and risk assessment on a scale of SCORE in groups of patients with and without MAC did not differ significantly. In patients with MAC was higher incidence of myocardial infarction (p = 0.024) and more often than in patients without MAC, diagnosed coronary heart disease (p = 0.029). In the multivariate analysis adjusted for age and total cholesterol level is set significantly associated with the presence and extent of MAC with symptomatic atherosclerotic peripheral arterial disease (p < 0,00001; β = 0,410).

Conclusion. In patients with MAC older than 65 years without diabetes, incidence of cardiovascular disease associated with atherosclerosis,
was significantly higher than in patients without MAC. There was a direct relationship with MAC patient's age and level of total cholesterol. No other risk factors for MAC common with cardiovascular diseases related to atherosclerosis in elderly patients were identified.

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