Abstract 13115: Risk Markers for Minimal Coronary Artery Calcification in Persons With Significant Aortic Valve Calcium: The Multi-Ethnic Study of Atherosclerosis
Bibliographic record
Abstract
Introduction: Calcific aortic valve disease is the most common valve disorder affecting >5 million US adults. The underlying pathobiology for the early stages of aortic valve calcification (AVC) and coronary artery calcium (CAC) includes many shared ASCVD risk factors, but a considerable proportion of individuals with significant AVC have little to no CAC. Hypothesis: Among persons with significant AVC (>100 AU), those with a low CAC burden (CAC <100 AU) would be younger and have a lower prevalence of both traditional and novel ASCVD risk factors compared to persons with CAC ≥100. Methods: After excluding 2 persons with bicuspid aortic valve, 325 participants from the Multi-Ethnic Study of Atherosclerosis without clinical ASCVD and with AVC >100 at Visit 1 (2000-02) were included (34% women, 23% African American). We used Poisson regression to calculate adjusted prevalence ratios for CAC <100 versus CAC >100, using traditional and novel ASCVD risk markers. Results: Participants had a mean age of 72.1 years and 133 (41%) had CAC <100 of whom 46/133 had CAC=0. Those with CAC <100 were younger (70 vs. 74 years), had a lower prevalence of both hypertension (74% vs. 87%) and statin use (16% vs. 29%), but otherwise similar risk factor profiles compared to those with CAC ≥100. There were no significant differences in median Lp(a) (19.1 vs. 19.7 mg/dL) or hsCRP values (2.3 vs. 1.9 mg/L). A higher likelihood of CAC <100 was observed per 10 years younger age (PR=1.41, 95% CI: 1.22-1.62), female sex (PR=1.68, 95% CI: 1.28-2.20), and a total cholesterol-HDL cholesterol ratio <3.5 (PR=1.37, 95% CI: 1.02-1.85). There was no significant association between other individual risk factors and CAC <100, but an ASCVD risk of <7.5% had a prevalence ratio of 2.30 (95% CI: 1.85-2.85). Among nontraditional risk factors, only the absence of thoracic calcification was associated with a higher prevalence of CAC <100 (PR=1.71, 95% CI: 1.28-2.28). Conclusions: More than 40% of persons with significant AVC had a low burden of CAC, which is incompletely explained through traditional and novel ASCVD risk markers. These results suggest that unmeasured risk markers, genetics, and/or the non-ASCVD pathways of later stage AVC may be more important in understanding the observed discordance between AVC and CAC.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".