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==Overview==
==Overview==
The presence of aortic sclerosis has been suggested as a marker of increased cardiovascular risk, including increased mortality. However, it remains unclear whether aortic sclerosis is independently associated with risk or merely a marker of coexistent cardiovascular risk factors.<ref name="pmid21295189">{{cite journal |author=Gharacholou SM, Karon BL, Shub C, Pellikka PA |title=Aortic valve sclerosis and clinical outcomes: moving toward a definition |journal=[[The American Journal of Medicine]] |volume=124 |issue=2 |pages=103–10 |year=2011 |month=February |pmid=21295189 |doi=10.1016/j.amjmed.2010.10.012 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(10)00913-7 |accessdate=2012-04-10}}</ref>
Aortic sclerosis is non-obstructive degeneration of the aortic valve that presents predominantly in patients over 65 years of age who have risk factors for [[coronary artery disease]].  Because aortic sclerosis is associated with [[coronary artery disease]] risk factors, it is also associated with a significant increase in the risk of cardiovascular death, [[myocardial infarction]] even in the absence of hemodynamically significant [[LVOT|left ventricular outflow tract obstruction]]. However, it remains unclear whether aortic sclerosis is independently associated with risk or merely a marker of coexistent cardiovascular risk factors.<ref name="pmid21295189">{{cite journal |author=Gharacholou SM, Karon BL, Shub C, Pellikka PA |title=Aortic valve sclerosis and clinical outcomes: moving toward a definition |journal=[[The American Journal of Medicine]] |volume=124 |issue=2 |pages=103–10 |year=2011 |month=February |pmid=21295189 |doi=10.1016/j.amjmed.2010.10.012 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(10)00913-7 |accessdate=2012-04-10}}</ref>


==Risk Factors==
==Risk Factors for Aortic Sclerosis==
*Based on a large cohort study,<ref name="pmid9060903">{{cite journal |author=Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM |title=Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study |journal=[[Journal of the American College of Cardiology]] |volume=29 |issue=3 |pages=630–4 |year=1997 |month=March |pmid=9060903 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109796005633 |accessdate=2012-04-10}}</ref> independent clinical factors associated with aortic sclerosis include:
*'''''Independent clinical factors''''' that is associated with increased incidence of [[aortic sclerosis]] include:
:*Age (twofold increased risk for each 10-year increase in age),
:*Age ''(twofold increased risk for each 10-year increase in age)''<ref name="pmid9060903">{{cite journal |author=Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM |title=Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study |journal=[[Journal of the American College of Cardiology]] |volume=29 |issue=3 |pages=630–4 |year=1997 |month=March |pmid=9060903 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109796005633 |accessdate=2012-04-10}}</ref><ref name="pmid20185020">{{cite journal |author=Owens DS, Katz R, Takasu J, Kronmal R, Budoff MJ, O'Brien KD |title=Incidence and progression of aortic valve calcium in the Multi-ethnic Study of Atherosclerosis (MESA) |journal=[[The American Journal of Cardiology]] |volume=105 |issue=5 |pages=701–8 |year=2010 |month=March |pmid=20185020 |pmc=2829478 |doi=10.1016/j.amjcard.2009.10.071 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(09)02766-0 |accessdate=2012-04-11}}</ref>
:*Male gender (twofold excess risk),  
:*Male gender ''(twofold excess risk)''<ref name="pmid9060903">{{cite journal |author=Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM |title=Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study |journal=[[Journal of the American College of Cardiology]] |volume=29 |issue=3 |pages=630–4 |year=1997 |month=March |pmid=9060903 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109796005633 |accessdate=2012-04-10}}</ref><ref name="pmid20185020">{{cite journal |author=Owens DS, Katz R, Takasu J, Kronmal R, Budoff MJ, O'Brien KD |title=Incidence and progression of aortic valve calcium in the Multi-ethnic Study of Atherosclerosis (MESA) |journal=[[The American Journal of Cardiology]] |volume=105 |issue=5 |pages=701–8 |year=2010 |month=March |pmid=20185020 |pmc=2829478 |doi=10.1016/j.amjcard.2009.10.071 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(09)02766-0 |accessdate=2012-04-11}}</ref>
:*Present smoking (35% increase in risk),
:*Present smoking ''(35% increase in risk)''<ref name="pmid9060903">{{cite journal |author=Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM |title=Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study |journal=[[Journal of the American College of Cardiology]] |volume=29 |issue=3 |pages=630–4 |year=1997 |month=March |pmid=9060903 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109796005633 |accessdate=2012-04-10}}</ref><ref name="pmid20185020">{{cite journal |author=Owens DS, Katz R, Takasu J, Kronmal R, Budoff MJ, O'Brien KD |title=Incidence and progression of aortic valve calcium in the Multi-ethnic Study of Atherosclerosis (MESA) |journal=[[The American Journal of Cardiology]] |volume=105 |issue=5 |pages=701–8 |year=2010 |month=March |pmid=20185020 |pmc=2829478 |doi=10.1016/j.amjcard.2009.10.071 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(09)02766-0 |accessdate=2012-04-11}}</ref><ref name="pmid19608594">{{cite journal |author=Stritzke J, Linsel-Nitschke P, Markus MR, Mayer B, Lieb W, Luchner A, Döring A, Koenig W, Keil U, Hense HW, Schunkert H |title=Association between degenerative aortic valve disease and long-term exposure to cardiovascular risk factors: results of the longitudinal population-based KORA/MONICA survey |journal=[[European Heart Journal]] |volume=30 |issue=16 |pages=2044–53 |year=2009 |month=August |pmid=19608594 |doi=10.1093/eurheartj/ehp287 |url=http://eurheartj.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=19608594 |accessdate=2012-04-11}}</ref>
:*History of [[hypertension]] (20% increase in risk),
:*History of [[hypertension]] ''(20% increase in risk)''<ref name="pmid9060903">{{cite journal |author=Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM |title=Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study |journal=[[Journal of the American College of Cardiology]] |volume=29 |issue=3 |pages=630–4 |year=1997 |month=March |pmid=9060903 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109796005633 |accessdate=2012-04-10}}</ref><ref name="pmid20185020">{{cite journal |author=Owens DS, Katz R, Takasu J, Kronmal R, Budoff MJ, O'Brien KD |title=Incidence and progression of aortic valve calcium in the Multi-ethnic Study of Atherosclerosis (MESA) |journal=[[The American Journal of Cardiology]] |volume=105 |issue=5 |pages=701–8 |year=2010 |month=March |pmid=20185020 |pmc=2829478 |doi=10.1016/j.amjcard.2009.10.071 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(09)02766-0 |accessdate=2012-04-11}}</ref> with subsequent [[left ventricular hypertrophy]] <ref name="pmid15619412">{{cite journal |author=Olsen MH, Wachtell K, Bella JN, Gerdts E, Palmieri V, Nieminen MS, Smith G, Ibsen H, Devereux RB |title=Aortic valve sclerosis relates to cardiovascular events in patients with hypertension (a LIFE substudy) |journal=[[The American Journal of Cardiology]] |volume=95 |issue=1 |pages=132–6 |year=2005 |month=January |pmid=15619412 |doi=10.1016/j.amjcard.2004.08.080 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(04)01464-X |accessdate=2012-04-10}}</ref>
:*Height,
:*Height<ref name="pmid9060903">{{cite journal |author=Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM |title=Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study |journal=[[Journal of the American College of Cardiology]] |volume=29 |issue=3 |pages=630–4 |year=1997 |month=March |pmid=9060903 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109796005633 |accessdate=2012-04-10}}</ref><ref name="pmid20185020">{{cite journal |author=Owens DS, Katz R, Takasu J, Kronmal R, Budoff MJ, O'Brien KD |title=Incidence and progression of aortic valve calcium in the Multi-ethnic Study of Atherosclerosis (MESA) |journal=[[The American Journal of Cardiology]] |volume=105 |issue=5 |pages=701–8 |year=2010 |month=March |pmid=20185020 |pmc=2829478 |doi=10.1016/j.amjcard.2009.10.071 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(09)02766-0 |accessdate=2012-04-11}}</ref>
:*High lipoprotein(a) and [[LDL|low density lipoprotein cholesterol]] levels.  
:*Elevated lipoprotein(a) and elevated [[LDL|low density lipoprotein cholesterol]] levels<ref name="pmid9060903">{{cite journal |author=Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM |title=Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study |journal=[[Journal of the American College of Cardiology]] |volume=29 |issue=3 |pages=630–4 |year=1997 |month=March |pmid=9060903 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109796005633 |accessdate=2012-04-10}}</ref><ref name="pmid20185020">{{cite journal |author=Owens DS, Katz R, Takasu J, Kronmal R, Budoff MJ, O'Brien KD |title=Incidence and progression of aortic valve calcium in the Multi-ethnic Study of Atherosclerosis (MESA) |journal=[[The American Journal of Cardiology]] |volume=105 |issue=5 |pages=701–8 |year=2010 |month=March |pmid=20185020 |pmc=2829478 |doi=10.1016/j.amjcard.2009.10.071 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(09)02766-0 |accessdate=2012-04-11}}</ref><ref name="pmid11602496">{{cite journal |author=Pohle K, Mäffert R, Ropers D, Moshage W, Stilianakis N, Daniel WG, Achenbach S |title=Progression of aortic valve calcification: association with coronary atherosclerosis and cardiovascular risk factors |journal=[[Circulation]] |volume=104 |issue=16 |pages=1927–32 |year=2001 |month=October |pmid=11602496 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=11602496 |accessdate=2012-04-11}}</ref><ref name="pmid3565291">{{cite journal |author=Aronow WS, Schwartz KS, Koenigsberg M |title=Correlation of serum lipids, calcium, and phosphorus, diabetes mellitus and history of systemic hypertension with presence or absence of calcified or thickened aortic cusps or root in elderly patients |journal=[[The American Journal of Cardiology]] |volume=59 |issue=9 |pages=998–9 |year=1987 |month=April |pmid=3565291 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/0002-9149(87)91144-1 |accessdate=2012-04-11}}</ref><ref name="pmid7484833">{{cite journal |author=Gotoh T, Kuroda T, Yamasawa M, Nishinaga M, Mitsuhashi T, Seino Y, Nagoh N, Kayaba K, Yamada S, Matsuo H |title=Correlation between lipoprotein(a) and aortic valve sclerosis assessed by echocardiography (the JMS Cardiac Echo and Cohort Study) |journal=[[The American Journal of Cardiology]] |volume=76 |issue=12 |pages=928–32 |year=1995 |month=November |pmid=7484833 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S000291499980263X |accessdate=2012-04-11}}</ref><ref name="pmid19608594">{{cite journal |author=Stritzke J, Linsel-Nitschke P, Markus MR, Mayer B, Lieb W, Luchner A, Döring A, Koenig W, Keil U, Hense HW, Schunkert H |title=Association between degenerative aortic valve disease and long-term exposure to cardiovascular risk factors: results of the longitudinal population-based KORA/MONICA survey |journal=[[European Heart Journal]] |volume=30 |issue=16 |pages=2044–53 |year=2009 |month=August |pmid=19608594 |doi=10.1093/eurheartj/ehp287 |url=http://eurheartj.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=19608594 |accessdate=2012-04-11}}</ref>
:*[[ESRD|End-stage renal disease]] on [[Dialysis|maintenance dialysis]].<ref name="pmid1554541">{{cite journal |author=Straumann E, Meyer B, Misteli M, Blumberg A, Jenzer HR |title=Aortic and mitral valve disease in patients with end stage renal failure on long-term haemodialysis |journal=[[British Heart Journal]] |volume=67 |issue=3 |pages=236–9 |year=1992 |month=March |pmid=1554541 |pmc=1024798 |doi= |url=http://heart.bmj.com/cgi/pmidlookup?view=long&pmid=1554541 |accessdate=2012-04-10}}</ref><ref name="pmid7817230">{{cite journal |author=Stinebaugh J, Lavie CJ, Milani RV, Cassidy MM, Figueroa JE |title=Doppler echocardiographic assessment of valvular heart disease in patients requiring hemodialysis for end-stage renal disease |journal=[[Southern Medical Journal]] |volume=88 |issue=1 |pages=65–71 |year=1995 |month=January |pmid=7817230 |doi= |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0038-4348&volume=88&issue=1&spage=65 |accessdate=2012-04-10}}</ref>
:*[[Metabolic syndrome]] and [[diabetes mellitus]]<ref name="pmid16636166">{{cite journal |author=Katz R, Wong ND, Kronmal R, Takasu J, Shavelle DM, Probstfield JL, Bertoni AG, Budoff MJ, O'Brien KD |title=Features of the metabolic syndrome and diabetes mellitus as predictors of aortic valve calcification in the Multi-Ethnic Study of Atherosclerosis |journal=[[Circulation]] |volume=113 |issue=17 |pages=2113–9 |year=2006 |month=May |pmid=16636166 |doi=10.1161/CIRCULATIONAHA.105.598086 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=16636166 |accessdate=2012-04-11}}</ref>


*In addition to the presence of coronary risk factors, the presence of multiple calcium deposits in the mitral annulus, aortic valve or aortic root has shown to be a predictable marker of [[coronary artery disease]] among the elderly population.<ref name="pmid11738305">{{cite journal |author=Jeon DS, Atar S, Brasch AV, Luo H, Mirocha J, Naqvi TZ, Kraus R, Berman DS, Siegel RJ |title=Association of mitral annulus calcification, aortic valve sclerosis and aortic root calcification with abnormal myocardial perfusion single photon emission tomography in subjects age < or &amp;#61;65 years old |journal=[[Journal of the American College of Cardiology]] |volume=38 |issue=7 |pages=1988–93 |year=2001 |month=December |pmid=11738305 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109701016783 |accessdate=2012-04-10}}</ref><ref name="pmid12505585">{{cite journal |author=Faggiano P, Antonini-Canterin F, Erlicher A, Romeo C, Cervesato E, Pavan D, Piazza R, Huang G, Nicolosi GL |title=Progression of aortic valve sclerosis to aortic stenosis |journal=[[The American Journal of Cardiology]] |volume=91 |issue=1 |pages=99–101 |year=2003 |month=January |pmid=12505585 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0002914902030114 |accessdate=2012-04-10}}</ref>
*The '''''MESA study''''' quantified [[aortic valve calcification]] by serial computed tomographic images from 5,880 participants aged 45 to 84 years reported an 1.7% per year incidence rate of [[aortic valve calcification]] which increased significantly with age.<ref name="pmid20185020">{{cite journal |author=Owens DS, Katz R, Takasu J, Kronmal R, Budoff MJ, O'Brien KD |title=Incidence and progression of aortic valve calcium in the Multi-ethnic Study of Atherosclerosis (MESA) |journal=[[The American Journal of Cardiology]] |volume=105 |issue=5 |pages=701–8 |year=2010 |month=March |pmid=20185020 |pmc=2829478 |doi=10.1016/j.amjcard.2009.10.071 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(09)02766-0 |accessdate=2012-04-11}}</ref>
 
==Aortic Sclerosis as a Risk Factor for Coronary Artery Disease==
*In addition to the presence of traditional risk factors for [[coronary artery disease]] such as [[hypertension]],<ref name="pmid15619412">{{cite journal |author=Olsen MH, Wachtell K, Bella JN, Gerdts E, Palmieri V, Nieminen MS, Smith G, Ibsen H, Devereux RB |title=Aortic valve sclerosis relates to cardiovascular events in patients with hypertension (a LIFE substudy) |journal=[[The American Journal of Cardiology]] |volume=95 |issue=1 |pages=132–6 |year=2005 |month=January |pmid=15619412 |doi=10.1016/j.amjcard.2004.08.080 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(04)01464-X |accessdate=2012-04-11}}</ref> [[diabetes]],<ref name="pmid16636166">{{cite journal |author=Katz R, Wong ND, Kronmal R, Takasu J, Shavelle DM, Probstfield JL, Bertoni AG, Budoff MJ, O'Brien KD |title=Features of the metabolic syndrome and diabetes mellitus as predictors of aortic valve calcification in the Multi-Ethnic Study of Atherosclerosis |journal=[[Circulation]] |volume=113 |issue=17 |pages=2113–9 |year=2006 |month=May |pmid=16636166 |doi=10.1161/CIRCULATIONAHA.105.598086 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=16636166 |accessdate=2012-04-11}}</ref> [[hyperlipidemia]]<ref name="pmid11602496">{{cite journal |author=Pohle K, Mäffert R, Ropers D, Moshage W, Stilianakis N, Daniel WG, Achenbach S |title=Progression of aortic valve calcification: association with coronary atherosclerosis and cardiovascular risk factors |journal=[[Circulation]] |volume=104 |issue=16 |pages=1927–32 |year=2001 |month=October |pmid=11602496 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=11602496 |accessdate=2012-04-11}}</ref><ref name="pmid3565291">{{cite journal |author=Aronow WS, Schwartz KS, Koenigsberg M |title=Correlation of serum lipids, calcium, and phosphorus, diabetes mellitus and history of systemic hypertension with presence or absence of calcified or thickened aortic cusps or root in elderly patients |journal=[[The American Journal of Cardiology]] |volume=59 |issue=9 |pages=998–9 |year=1987 |month=April |pmid=3565291 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/0002-9149(87)91144-1 |accessdate=2012-04-11}}</ref><ref name="pmid7484833">{{cite journal |author=Gotoh T, Kuroda T, Yamasawa M, Nishinaga M, Mitsuhashi T, Seino Y, Nagoh N, Kayaba K, Yamada S, Matsuo H |title=Correlation between lipoprotein(a) and aortic valve sclerosis assessed by echocardiography (the JMS Cardiac Echo and Cohort Study) |journal=[[The American Journal of Cardiology]] |volume=76 |issue=12 |pages=928–32 |year=1995 |month=November |pmid=7484833 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S000291499980263X |accessdate=2012-04-11}}</ref> and [[smoking]], the presence of [[Mitral annular calcification|multiple calcium deposits in the mitral annulus]], [[aortic sclerosis|aortic valve]] or aortic root have been shown to be a predictor of [[coronary artery disease]] among elderly patients with [[aortic sclerosis]].<ref name="pmid11527641">{{cite journal |author=Agmon Y, Khandheria BK, Meissner I, Sicks JR, O'Fallon WM, Wiebers DO, Whisnant JP, Seward JB, Tajik AJ |title=Aortic valve sclerosis and aortic atherosclerosis: different manifestations of the same disease? Insights from a population-based study |journal=[[Journal of the American College of Cardiology]] |volume=38 |issue=3 |pages=827–34 |year=2001 |month=September |pmid=11527641 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S073510970101422X |accessdate=2012-04-11}}</ref><ref name="pmid9060903">{{cite journal |author=Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM |title=Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study |journal=[[Journal of the American College of Cardiology]] |volume=29 |issue=3 |pages=630–4 |year=1997 |month=March |pmid=9060903 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109796005633 |accessdate=2012-04-11}}</ref><ref name="pmid15670554">{{cite journal |author=Taylor HA, Clark BL, Garrison RJ, Andrew ME, Han H, Fox ER, Arnett DK, Samdarshi T, Jones DW |title=Relation of aortic valve sclerosis to risk of coronary heart disease in African-Americans |journal=[[The American Journal of Cardiology]] |volume=95 |issue=3 |pages=401–4 |year=2005 |month=February |pmid=15670554 |doi=10.1016/j.amjcard.2004.09.043 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(04)01611-X |accessdate=2012-04-11}}</ref><ref name="pmid11738305">{{cite journal |author=Jeon DS, Atar S, Brasch AV, Luo H, Mirocha J, Naqvi TZ, Kraus R, Berman DS, Siegel RJ |title=Association of mitral annulus calcification, aortic valve sclerosis and aortic root calcification with abnormal myocardial perfusion single photon emission tomography in subjects age < or &amp;#61;65 years old |journal=[[Journal of the American College of Cardiology]] |volume=38 |issue=7 |pages=1988–93 |year=2001 |month=December |pmid=11738305 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735109701016783 |accessdate=2012-04-10}}</ref><ref name="pmid12505585">{{cite journal |author=Faggiano P, Antonini-Canterin F, Erlicher A, Romeo C, Cervesato E, Pavan D, Piazza R, Huang G, Nicolosi GL |title=Progression of aortic valve sclerosis to aortic stenosis |journal=[[The American Journal of Cardiology]] |volume=91 |issue=1 |pages=99–101 |year=2003 |month=January |pmid=12505585 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0002914902030114 |accessdate=2012-04-10}}</ref>
 
*The '''''Heart and Soul study''''' evaluated 814 outpatients with established [[coronary heart disease]] and no evidence of [[aortic stenosis]], to examine the association of [[aortic sclerosis]] with subsequent cardiovascular events. At baseline, 40% of the enrolled subjects had aortic sclerosis. During 4-year follow-up, a significant number of patients with aortic sclerosis experienced [[myocardial infarction]] in comparison to patients without aortic sclerosis: 10% versus 5% ''(HR 1.8; 95%CI,1.1-3.1; P=0.02)''. Additionally, the association between aortic sclerosis and [[MI]] appeared to differ by [[statin]] use ''(P=0.15 for interaction)''. Thus, the study concluded [[aortic sclerosis]] was independently associated with a '''2.4-fold increased rate''' of subsequent [[MI]]. Furthermore, administration of [[statins]] attenuated the risk of future [[MI]] in patients with aortic sclerosis.<ref name="pmid17437741">{{cite journal |author=Shah SJ, Ristow B, Ali S, Na BY, Schiller NB, Whooley MA |title=Acute myocardial infarction in patients with versus without aortic valve sclerosis and effect of statin therapy (from the Heart and Soul Study) |journal=[[The American Journal of Cardiology]] |volume=99 |issue=8 |pages=1128–33 |year=2007 |month=April |pmid=17437741 |pmc=2778470 |doi=10.1016/j.amjcard.2006.11.057 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9149(07)00065-3 |accessdate=2012-04-11}}</ref>


==References==
==References==
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[[CME Category::Cardiology]]


[[Category:Disease]]
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[[Category:Cardiology]]

Latest revision as of 23:04, 14 March 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]

Overview

Aortic sclerosis is non-obstructive degeneration of the aortic valve that presents predominantly in patients over 65 years of age who have risk factors for coronary artery disease. Because aortic sclerosis is associated with coronary artery disease risk factors, it is also associated with a significant increase in the risk of cardiovascular death, myocardial infarction even in the absence of hemodynamically significant left ventricular outflow tract obstruction. However, it remains unclear whether aortic sclerosis is independently associated with risk or merely a marker of coexistent cardiovascular risk factors.[1]

Risk Factors for Aortic Sclerosis

  • Independent clinical factors that is associated with increased incidence of aortic sclerosis include:

Aortic Sclerosis as a Risk Factor for Coronary Artery Disease

  • The Heart and Soul study evaluated 814 outpatients with established coronary heart disease and no evidence of aortic stenosis, to examine the association of aortic sclerosis with subsequent cardiovascular events. At baseline, 40% of the enrolled subjects had aortic sclerosis. During 4-year follow-up, a significant number of patients with aortic sclerosis experienced myocardial infarction in comparison to patients without aortic sclerosis: 10% versus 5% (HR 1.8; 95%CI,1.1-3.1; P=0.02). Additionally, the association between aortic sclerosis and MI appeared to differ by statin use (P=0.15 for interaction). Thus, the study concluded aortic sclerosis was independently associated with a 2.4-fold increased rate of subsequent MI. Furthermore, administration of statins attenuated the risk of future MI in patients with aortic sclerosis.[16]

References

  1. ↑ Gharacholou SM, Karon BL, Shub C, Pellikka PA (2011). "Aortic valve sclerosis and clinical outcomes: moving toward a definition". The American Journal of Medicine. 124 (2): 103–10. doi:10.1016/j.amjmed.2010.10.012. PMID 21295189. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)
  2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, Kitzman DW, Otto CM (1997). "Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study". Journal of the American College of Cardiology. 29 (3): 630–4. PMID 9060903. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)
  3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 Owens DS, Katz R, Takasu J, Kronmal R, Budoff MJ, O'Brien KD (2010). "Incidence and progression of aortic valve calcium in the Multi-ethnic Study of Atherosclerosis (MESA)". The American Journal of Cardiology. 105 (5): 701–8. doi:10.1016/j.amjcard.2009.10.071. PMC 2829478. PMID 20185020. Retrieved 2012-04-11. Unknown parameter |month= ignored (help)
  4. ↑ 4.0 4.1 Stritzke J, Linsel-Nitschke P, Markus MR, Mayer B, Lieb W, Luchner A, Döring A, Koenig W, Keil U, Hense HW, Schunkert H (2009). "Association between degenerative aortic valve disease and long-term exposure to cardiovascular risk factors: results of the longitudinal population-based KORA/MONICA survey". European Heart Journal. 30 (16): 2044–53. doi:10.1093/eurheartj/ehp287. PMID 19608594. Retrieved 2012-04-11. Unknown parameter |month= ignored (help)
  5. ↑ 5.0 5.1 Olsen MH, Wachtell K, Bella JN, Gerdts E, Palmieri V, Nieminen MS, Smith G, Ibsen H, Devereux RB (2005). "Aortic valve sclerosis relates to cardiovascular events in patients with hypertension (a LIFE substudy)". The American Journal of Cardiology. 95 (1): 132–6. doi:10.1016/j.amjcard.2004.08.080. PMID 15619412. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)
  6. ↑ 6.0 6.1 Pohle K, Mäffert R, Ropers D, Moshage W, Stilianakis N, Daniel WG, Achenbach S (2001). "Progression of aortic valve calcification: association with coronary atherosclerosis and cardiovascular risk factors". Circulation. 104 (16): 1927–32. PMID 11602496. Retrieved 2012-04-11. Unknown parameter |month= ignored (help)
  7. ↑ 7.0 7.1 Aronow WS, Schwartz KS, Koenigsberg M (1987). "Correlation of serum lipids, calcium, and phosphorus, diabetes mellitus and history of systemic hypertension with presence or absence of calcified or thickened aortic cusps or root in elderly patients". The American Journal of Cardiology. 59 (9): 998–9. PMID 3565291. Retrieved 2012-04-11. Unknown parameter |month= ignored (help)
  8. ↑ 8.0 8.1 Gotoh T, Kuroda T, Yamasawa M, Nishinaga M, Mitsuhashi T, Seino Y, Nagoh N, Kayaba K, Yamada S, Matsuo H (1995). "Correlation between lipoprotein(a) and aortic valve sclerosis assessed by echocardiography (the JMS Cardiac Echo and Cohort Study)". The American Journal of Cardiology. 76 (12): 928–32. PMID 7484833. Retrieved 2012-04-11. Unknown parameter |month= ignored (help)
  9. ↑ Straumann E, Meyer B, Misteli M, Blumberg A, Jenzer HR (1992). "Aortic and mitral valve disease in patients with end stage renal failure on long-term haemodialysis". British Heart Journal. 67 (3): 236–9. PMC 1024798. PMID 1554541. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)
  10. ↑ Stinebaugh J, Lavie CJ, Milani RV, Cassidy MM, Figueroa JE (1995). "Doppler echocardiographic assessment of valvular heart disease in patients requiring hemodialysis for end-stage renal disease". Southern Medical Journal. 88 (1): 65–71. PMID 7817230. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)
  11. ↑ 11.0 11.1 Katz R, Wong ND, Kronmal R, Takasu J, Shavelle DM, Probstfield JL, Bertoni AG, Budoff MJ, O'Brien KD (2006). "Features of the metabolic syndrome and diabetes mellitus as predictors of aortic valve calcification in the Multi-Ethnic Study of Atherosclerosis". Circulation. 113 (17): 2113–9. doi:10.1161/CIRCULATIONAHA.105.598086. PMID 16636166. Retrieved 2012-04-11. Unknown parameter |month= ignored (help)
  12. ↑ Agmon Y, Khandheria BK, Meissner I, Sicks JR, O'Fallon WM, Wiebers DO, Whisnant JP, Seward JB, Tajik AJ (2001). "Aortic valve sclerosis and aortic atherosclerosis: different manifestations of the same disease? Insights from a population-based study". Journal of the American College of Cardiology. 38 (3): 827–34. PMID 11527641. Retrieved 2012-04-11. Unknown parameter |month= ignored (help)
  13. ↑ Taylor HA, Clark BL, Garrison RJ, Andrew ME, Han H, Fox ER, Arnett DK, Samdarshi T, Jones DW (2005). "Relation of aortic valve sclerosis to risk of coronary heart disease in African-Americans". The American Journal of Cardiology. 95 (3): 401–4. doi:10.1016/j.amjcard.2004.09.043. PMID 15670554. Retrieved 2012-04-11. Unknown parameter |month= ignored (help)
  14. ↑ Jeon DS, Atar S, Brasch AV, Luo H, Mirocha J, Naqvi TZ, Kraus R, Berman DS, Siegel RJ (2001). "Association of mitral annulus calcification, aortic valve sclerosis and aortic root calcification with abnormal myocardial perfusion single photon emission tomography in subjects age < or &#61;65 years old". Journal of the American College of Cardiology. 38 (7): 1988–93. PMID 11738305. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)
  15. ↑ Faggiano P, Antonini-Canterin F, Erlicher A, Romeo C, Cervesato E, Pavan D, Piazza R, Huang G, Nicolosi GL (2003). "Progression of aortic valve sclerosis to aortic stenosis". The American Journal of Cardiology. 91 (1): 99–101. PMID 12505585. Retrieved 2012-04-10. Unknown parameter |month= ignored (help)
  16. ↑ Shah SJ, Ristow B, Ali S, Na BY, Schiller NB, Whooley MA (2007). "Acute myocardial infarction in patients with versus without aortic valve sclerosis and effect of statin therapy (from the Heart and Soul Study)". The American Journal of Cardiology. 99 (8): 1128–33. doi:10.1016/j.amjcard.2006.11.057. PMC 2778470. PMID 17437741. Retrieved 2012-04-11. Unknown parameter |month= ignored (help)

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