Correlation between Aortic Valve and Mitral Valve Calcification and Coronary Artery Disease by Using Computed Tomography Coronary Angiography

Background: Aortic valve calcification (AVC) and mitral annular calcification (MAC) are chronic degenerative processes frequently observed in elderly individuals and often coexist with coronary artery disease (CAD). The association between valvular calcification and CAD remains an area of ongoing investigation. Objective: This study aims to assess the correlation between AVC and MAC with the presence and severity of CAD using computed tomography coronary angiography (CTCA). Patients and methods: This prospective cross-sectional study included 100 patients (age 58–85 years) with echocardiographic evidence of AVC and/or MAC who underwent CTCA for suspected ischemic heart disease (IHD). Quantification of AVC was performed using the Agatston score, whereas MAC was categorized based on a predefined four-grade scale. Coronary artery lesions were classified based on the degree of stenosis. Results: Significant AVC demonstrated a robust association with CAD, present in 84.2% of cases compared to 8.3% without AVC (P < 0.001), and was most notably correlated with LAD artery involvement (93.9% vs. 11.8%, P < 0.001). Patients with significant AVC had a higher prevalence of single-vessel (60.6% vs. 29.4%) and multiple-vessel disease (36.4% vs. 5.9%) (P < 0.001). MAC was not substantially associated with CAD presence (P = 0.417), but severe/diffuse MAC correlated with multi-vessel disease (87.5%, P < 0.001). Conclusion: AVC was significantly associated with CAD, particularly LAD involvement, while MAC was linked to multi-vessel disease in severe cases. These findings highlight the potential role of valvular calcification as an imaging marker for CAD risk stratification.