Significance of aortic arch calcification as a cardiovascular risk marker: analysis of a cohort of hospitalized patients in internal medicine

Abstract

Introduction

Aortic arch calcification (AAC) is an underestimated marker of cardiovascular risk, associated with a higher incidence of major cardiovascular events and mortality.

Materials and methods

This retrospective, descriptive study included 292 patients admitted in May 2021 to the Internal Medicine Department of Marqués de Valdecilla University Hospital. The presence of AAC was assessed via chest X-rays, alongside clinical data, risk factors, and previous and 12-month cardiovascular events.

Results

AAC was present in 51% of patients. Age over 65, dyslipidemia, and smoking were independent predictors (p < 0.05). AAC was significantly associated with a higher prevalence of cardiovascular events: stroke (23.3% vs. 13.3%; OR 1.9, 95% CI 1.07–3.6), acute coronary syndrome (23.3% vs. 8.5%; OR 3.2, 95% CI 1.6–6.4), and peripheral arterial disease (20.9% vs. 7.3%; OR 3.3, 95% CI 1.6–6.9). At 12-month follow-up, patients with AAC had a higher incidence of new cardiovascular events (22.5% vs. 10.9%; OR 2.3, 95% CI 1.2–4.9; p = 0.007). Although overall survival was lower in this group, only age and chronic kidney disease were independent predictors of mortality.

Conclusions

AAC is a common finding among hospitalized patients and is associated with increased cardiovascular risk. Its detection on chest X-rays may serve as an accessible tool for risk stratification in high-risk populations.