Is the mitral annular calcification detected by transthoracic echocardiography a marker for coronary artery disease

The aim of this study was to test the hypothesis that mitral annular calcification detected by transthoracic echocardiography is a marker for coronary artery disease. Mitral annular calcification has been defined as a dense, highly reflective area at the base of the posterior mitral leaflet detected by transthoracic echocardiography. Fiftynine patients with mitral annular calcification (28 women and 31 men; mean age 72 ± 9 years), who underwent cardiac catheterization with coronary angiography for various reasons, were compared with fifty-three controls (21 women and 32 men; mean age 63 ± 6 years) without mitral annular calcification, who underwent coronary angiography for the same indications during the same period. Obsructive coronary artery disease was defined as either > or = 70% reduction of the internal diameter of the left anterior descending, right coronary, or left circumflex artery distribution. Compared with the controls, the group with mitral annular calcification had a significantly higher prevalence of coronary artery disease (86% vs. 66%, p = 0.001), as well as higher rates of 3-vessel disease (41% vs. 20%, p = 0.001) and left main coronary artery disease (10% vs. 2%, p = 0.001). Mitral annular calcification detected by transthoracic echocardiography may be a marker for the high prevalence and severity of coronary artery disease in the patients undergoing coronary angiography.