Aortic arch calcification and vascular disease: The guangzhou biobank cohort study

Objective: To examine the association between aortic arch calcification (AAC) and vascular disease in an older Chinese sample. Methods: For this study, 30,203 Chinese aged 50-85 years were recruited with baseline information on socioeconomic position, lifestyle and vascular risk factors. The presence and severity of AAC were diagnosed independently from chest X-ray by two radiologists. Results: The age-adjusted prevalence of AAC was significantly higher in women than men [34.6% (95% CI 33.9-35.3) vs. 27.9% (95% CI 26.8-28.8), p < 0.001]. Severity of AAC was significantly associated with physician-diagnosed ischemic heart disease (adjusted OR = 1.55, 95% CI 1.35-1.79) and combined vascular disease (OR = 1.48, 95% CI 1.30-1.69) after adjusting for multiple potential confounders. Increasing severity of AAC was associated with increased risk for ischemic heart disease and vascular disease (p for trend = 0.02 to <0.001). No association between AAC and stroke was found. Conclusions: AAC was strongly and independently associated with vascular disease, suggesting that assessment of AAC from chest X-ray, which is noninvasive and relatively inexpensive, can provide useful information for risk stratification of vascular disease, and should be routinely incorporated in chest X-ray examination.