ArticleCirculation. Cardiovascular imaging2026
Race and Ethnic-Specific Burden of Aortic Valve Calcium and Its Association With Long-Term Aortic Stenosis: Multi-Ethnic Study of Atherosclerosis.
Article in Circulation. Cardiovascular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRacial and ethnic differences have been reported for aortic valve calcium (AVC) and long-term aortic stenosis (AS). Whether these differences are due to differing risk factor profiles or the burden of AVC is unknown.
methodsBaseline AVC was quantified using the Agatston method among 6812 MESA (Multi-Ethnic Study of Atherosclerosis) participants. AVC scores were not reported to participants. The primary outcome of long-term moderate or severe AS was adjudicated using standard clinical criteria. We calculated multivariable Cox proportional hazards with log-transformed AVC as a continuous variable for each race and ethnicity.
resultsThe mean age was 62 years, and 47% of participants were women. Over a median follow-up of 16.7 years, 140 participants were diagnosed with moderate (n=56) and severe AS (n=84). The prevalence of baseline AVC >0 by self-reported race and ethnicity was White (15.8%), Hispanic (13.3%), Black (12.3%), and Chinese (8.3%). The rate of long-term incident moderate-severe AS was highest for White participants (2.1/1000 person-years) and lowest for Chinese participants (0.5/1000 person-years). The association of AVC with moderate-severe AS was significant for all race and ethnicity groups: White hazard ratio, 1.82 (95% CI, 1.62-2.03); Hispanic hazard ratio, 2.18 (95% CI, 1.82-2.62); Black hazard ratio, 2.28 (95% CI, 1.78-2.93); and Chinese hazard ratio, 3.65 (95% CI, 1.05-12.71) per 1 unit higher log transformed AVC. There was no interaction by race and ethnicity (
conclusionsThe racial and ethnic groups with a higher baseline prevalence of AVC had a higher long-term incidence of moderate-severe AS, but a similar relative association between AVC and moderate-severe AS regardless of baseline atherosclerotic cardiovascular disease risk. Our findings suggest that differences in AS by race and ethnicity may likely be explained by the burden of AVC.
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