Author + information
- Rayji Tsutsui,
- Kinjal Banerjee,
- Kimi Sato,
- James Thomas,
- Zoran Popovic and
- Samir Kapadia
Background: Warfarin is known to affect the synthesis and function of the vitamin K dependent matrix Gla-protein, which is a potent inhibitor of tissue calcification. Clinical association of warfarin use and degree of mitral annular calcification (MAC) progression is not known.
Methods: Database for the years 1996 through 2013 was searched for patients who had MAC and graded into none (0), mild (1), moderate (2), or severe (3). Patients were included if they had MAC at their index study and underwent ≥ 2 studies in the period of ≥ 2 years. Warfarin use was determined using the electronic medical record. Patients with prior mitral valve (MV) surgery or other identifiable MV disease were excluded. Peak and mean MV gradients and RVSP were evaluated.
Results: A total of 2995 patients (18794 studies) were included. Data are expressed as mean ± standard deviation. Age at index study was 71 ± 11 years. Follow up was 5.4 ± 3.2 years. Number of echocardiograms per patient was 5 ± 3. MAC severity was higher in patient on dialysis (0.5, n=72) vs non dialysis (0.3, n=2923, p < 0.001). There was no significant difference in proportion of patients with MAC progression with warfarin use (28.1% vs. 29.6%, p=0.36). Annual progression of MV gradients were faster with severe MAC compared to mild-moderate MAC with mean gradient 0.03 vs 0.16 mmHg, p<0.01; peak gradient 0.21 vs 0.32, p=0.003; RVSP 0.49 vs 0.68, p = 0.02.
Conclusions: Warfarin use was not independently associated with MAC progression. MV gradients progressed faster with severe MAC.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Valvular Heart Disease: Mitral Valve Disease
Abstract Category: 36. Valvular Heart Disease: Clinical
Presentation Number: 1145-027
- 2017 American College of Cardiology Foundation