Mitral Annular Calcification and Thromboembolic Risk

Thromboembolic (TE) risk scores used for atrial fibrillation (AF) patients do not include mitral annular calcification (MAC) as a potential indicator of vascular disease. This research evaluated the correlation between MAC and TE risk scores (CHADS(2) and CHA(2)DS(2)-VASc). We compared TE risk score values and clinical and echocardiographic data in patients with and without MAC. We included, prospectively, 103 patients: 40.8% with AF, 83.5% with hypertension, 30.1% with type II diabetes mellitus, 79.6% with chronic heart failure, and 7.8% with a history of stroke. We identified MAC in 50.5% of patients. The mean CHADS(2) and CHA(2)DS(2)-VASc scores were 2.56 & PLUSMN; 1.135 and 4.57 & PLUSMN; 1.61, respectively. In MAC patients, both scores tended to increase significantly compared with the control (2.88 & PLUSMN; 1.114 versus 2.24 & PLUSMN; 1.06, p = 0.005, and 5.21 & PLUSMN; 1.51 versus 3.92 & PLUSMN; 1.46, p < 0.001, respectively). The left ventricular ejection fraction negatively correlated with the presence of MAC (r = -0.254, p = 0.01). The presence of MAC was a risk factor for vascular disease (OR = 2.47, & chi;(2) = 34.32, p < 0001). Conclusions: The presence of MAC is associated with greater TE risk scores and a higher risk of vascular disease. It appears that adding MAC as a vascular disease parameter to TE risk scores may have benefits for patients by improving their predictive value.