Association of echocardiographic cardiac valve calcification with major adverse cardiovascular events in patients on acute myocardial infarction

BACKGROUNDThe role of cardiac valve calcification (CVC) in secondary prevention post-acute myocardial infarction (AMI) remains unclear. This study investigated the association between CVC and major adverse cardiovascular events (MACE) in AMI. METHODS AND RESULTSAMI patients hospitalized in Peking University First Hospital were consecutively enrolled. Participants were grouped according to the measurement of transthoracic echocardiography on admission. According to aortic valve calcification (AVC) and mitral annular calcification (MAC), patients were divided into Group 1 (with no valve calcification), Group 2 (with single valve calcification) and Group 3 (with both valve calcification). The primary endpoint was MACE (defined as a composite of nonfatal stroke, nonfatal myocardial infarction and cardiac death). A cohort of 911 AMI patients was recruited in this retrospective study. There were 513(56.31%), 337(36.99%) and 61(6.70%) in Group 1, Group 2 and Group 3, respectively. During follow-up (median, 5.11 years), 277(30.41%) patients developed MACE, 94(10.32%) had nonfatal stroke, 155(17.01%) had recurrent myocardial infarction (MI) and 106(11.64%) were identified as cardiac death. Comparing with Group 1, the adjusted hazard ratios (HR) for primary endpoint and recurrent MI in Group 3 was 1.61 (1.06, 2.43) and 1.70 (1.00, 2.89), respectively. And the adjusted HR of primary endpoint and cardiac death in moderate and severe AVC group was 1.50 (1.01, 2.23) and 1.97 (1.10, 3.51) compared with non-AVC group. CONCLUSIONSAMI patients with CVC were at significantly increased risk of MACE, although existing differences of the position and the severity of calcification. Screening for AVC and MAC is necessary in secondary prevention. RESEARCH PERSPECTIVE What Is New?O_LIThis study is the first to detail the association between cardiac valve calcification (CVC), specifically aortic valve calcification (AVC) and mitral annular calcification (MAC), with major adverse cardiovascular events (MACE) in patients after an acute myocardial infarction (AMI). C_LIO_LIIt also identifies the concurrent presence of MAC and AVC as an independent predictor of MACE. C_LI What Are the Clinical Implications?O_LIThe stud y suggests that screening for AVC and MAC post-AMI could help identify patients at higher risk of MACE, leading to more targeted preventive care and potentially improving outcomes. C_LI