Mitral annular calcification linked to higher heart failure risks
Patients with mitral annular calcification (MAC) face an increased risk of developing heart failure with preserved ejection fraction (HFpEF), according to new findings published in The American Journal of Cardiology.[1] In fact, MAC appears to influence the odds of developing HFpEF much more than BMI.
Prior research linked MAC with mortality, valvular disease and cardiovascular disease. Until this analysis, however, its connection to HFpEF, was largely unexplored.
The study’s authors actually performed three separate analyses. All data came from the TriNetX U.S. Collaborative Network, which gathers information from 71 different healthcare organizations.
First, researchers used propensity matching to compare 10,629 hospitalized patients with MAC with another 10,629 hospitalized patients without MAC. All patients were adults over the age of 50 years old. Any patients with a history of heart failure were excluded.
Overall, the group found that patients with MAC were 3.8 times more likely to develop HFpEF, 2.2 times as likely to develop heart failure with reduced ejection fraction (HFrEF) and 2.8 times as likely to develop any type of heart failure than patients without MAC.
The group’s second analysis focused on comparing 3,117 patients with HFpEF and MAC with 3.117 patients with HFpEF, but no MAC. After one year, patients with HFpEF and MAC faced a significantly higher risk of experiencing a heart failure hospitalization, all-cause hospitalization or ICU admission. In addition, these patients were 2.4 times as likely to undergo a prosthetic valve replacement and 2.1 times as likely to require a permanent pacemaker.
“They were also at greater risk for many cardiovascular comorbidities including ischemic heart disease, cerebrovascular disease, and aortic stenosis, and were at greater risk of acute renal failure,” the authors wrote. “Finally, though the numbers are small, there were significantly more MAC patients who developed cardiogenic shock.”
Finally, the authors stratified patients with and without MAC by their BMI. Heart failure risks were consistently much higher for MAC patients than patients without MAC, but there was one exception; the most obese group, with a BMI of 35 or higher, did faced a higher risk of HFpEF, but not HFrEF. This is similar to the “obesity paradox” identified with other cardiovascular diseases.
“The really surprising finding was that incidence rates in the MAC group ranged from 5% to 8.4% at one year, markedly higher than in the no-MAC group,” senior author Gregg Pressman, MD, a cardiologist with Jefferson Einstein Philadelphia Hospital, told Cardiovascular Business. “The take-home message is that, while most physicians recognize obesity as a major risk factor for the development of HFpEF, incidence rates in MAC patients—regardless of BMI—were many times greater than in the obese no-MAC patients.”
Click here to read the full analysis.
Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.