Non-coronary cardiac calcifications and outcomes in patients with heart failure. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Topaz, Guy; Yehezkel, Eyal; Benchetrit, Sydney; Korzets, Ze'ev; Arnson, Yoav; Kitay-Cohen, Yona; Pereg, David; Cohen-Hagai, Keren
• Is Part Of: Journal of cardiology. Volume 77:Issue 1(2021)
• Page Start: 83
• Page End: 87
• Publication Date: 2021-01
• Subjects: Cardiac calcifications -- Heart failure -- Mortality -- Recurrent hospitalizations; Cardiology -- Periodicals; 616.12
• DOI: 10.1016/j.jjcc.2020.07.019
• Languages: English
• ISSNs: 0914-5087

Abstract

Highlights: Medical records of ambulatory patients with heart failure were reviewed. Among 814 patients, 464 (57%) had non-coronary cardiac calcifications. Patients with calcifications had more hospitalizations for heart failure. The OR for all-cause death, HF hospitalizations, and the composite endpoint were greater in patients with calcifications. Calcifications should be included in risk stratification for heart failure. Abstract: Background: Calcium deposits on heart valves are considered a local manifestation of atherosclerosis and are associated with poor cardiovascular outcomes. The clinical significance of cardiac calcifications among heart failure (HF) patients, as assessed by echocardiography, is unknown. This study evaluated associations of cardiac calcifications with mortality and hospital admissions in this specific population. Methods: Medical records of all patients who initiated ambulatory surveillance at our HF clinic during 2011–2018 were reviewed. Calcifications in the aortic valve, aortic root, or the mitral valve were evaluated. Patients with moderate to severe regurgitation or stenosis of the aortic or mitral valves were excluded. The primary endpoint was the composite of long-term all-cause mortality and HF hospitalizations. Secondary endpoints were long-term all-cause mortality and more than one hospitalization due to HF. Results: This retrospective study included 814 patients (mean age 70.9 ± 13 years, 63.2% male). Of the total cohort, 350 (43%) had no cardiac calcifications and 464 (57%) had at least 1 calcified site. Considering the patients with no calcification as the reference group yielded a higher adjusted odds ratios for the composite endpoint, all-cause death, and recurrent HF hospitalizations, among patients with any cardiac calcification (OR = 1.68, 95%CI = 1.1–2.5, p = 0.01, OR=1.61, 95%CI = 1.1–2.3, p < 0.01, and OR = 1.50, 95%CI = 1.1–2.2, p < 0.01, respectively). Conclusions: We found an independent association between cardiac calcifications and the risk of death and HF hospitalizations among ambulatory HF patients. Cardiac calcifications evaluated during routine echocardiography may contribute to the risk stratification of patients with HF.