{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:52:47Z","timestamp":1790301167436,"version":"4.1.0"},"reference-count":24,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:00:00Z","timestamp":1761264000000},"content-version":"unspecified","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,10,1]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore the association between the degree of coronary artery calcium (CAC) and the progression of calcific aortic valve disease (CAVD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A single-centre retrospective cohort study using a hospital-based database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 2898 patients who underwent coronary CT angiography and serial echocardiograms at \u22656 months apart were included. Initial echocardiography was performed within 6 months from the time of CCTA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>CAC was divided into four groups: 0, 1\u201399, 100\u2013399 and \u2265400 (Agatston units, AU). The progression of CAVD was defined in two ways: progression 1 as at least one grade of progression, progression 2 as at least moderate aortic stenosis (AS) at follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At the initial CAVD grade, patients with at least mild AS tended to increase with increasing CAC (p&lt;0.001). During a median follow-up of 3.2 years (IQR, 1.8\u20135.0 years), 101 patients (3.5%) experienced progression 1 and 24 patients (0.8%) suffered progression 2. There was a statistically significant increase in risk of progression 1 in CAC 100\u2013399 and \u2265400 groups than CAC 0 and 1\u201399 groups (p&lt;0.001). In progression 2, the CAC\u2265400 group showed a higher progression rate than the other groups (p&lt;0.001). In multivariable logistic regression, age (adjusted OR (aOR), 1.06; 95%\u2009CI, 1.02 to 1.09; p=0.001), CAC\u2265400 (aOR, 2.55 vs CAC 0 as a reference group; 95%\u2009CI, 1.19 to 5.46; p=0.016), body mass index (aOR, 1.09; 95%\u2009CI, 1.02 to 1.17; p=0.010) and initial peak aortic jet velocity (aOR, 1.21 per 0.1 m\/s increase; 95%\u2009CI, 1.14 to 1.28; p&lt;0.001) were associated with progression 1. In progression 2, CAC\u2265400 (aOR, 44.5 vs CAC 0 as a reference group; 95%\u2009CI, 1.09 to 1810; p=0.045), eGFR (aOR, 0.88; 95%\u2009CI, 0.80 to 0.97; p=0.007), left ventricular mass index (aOR, 1.05; 95%\u2009CI, 1.01 to 1.10; p=0.029) and initial peak aortic jet velocity (aOR, 4.21 per 0.1 m\/s increase; 95%\u2009CI, 1.86 to 9.53; p=0.001) were significant determinants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CAC was significantly associated with the progression of CAVD. Particularly, CAC\u2265400 was linked to progression toward significant AS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-107349","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T07:35:32Z","timestamp":1761291332000},"page":"e107349","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Association between coronary artery calcium and the progression of calcific aortic valve disease: a hospital population-based observational retrospective cohort study"],"prefix":"10.1136","volume":"15","author":[{"given":"Hun-Tae","family":"Kim","sequence":"first","affiliation":[{"name":"Cardiology, Pohang Semyeong Christianity Hospital, Pohang-si, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2939-1714","authenticated-orcid":false,"given":"Jeong Hun","family":"Seo","sequence":"additional","affiliation":[{"name":"Cardiology, Pohang Semyeong Christianity Hospital, Pohang-si, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun Ho","family":"Bae","sequence":"additional","affiliation":[{"name":"Cardiology, Pohang Semyeong Christianity Hospital, Pohang-si, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Cardiology, Pohang Semyeong Christianity Hospital, Pohang-si, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"You Min","family":"Kim","sequence":"additional","affiliation":[{"name":"Cardiology, Pohang Semyeong Christianity Hospital, Pohang-si, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyunsu","family":"Jo","sequence":"additional","affiliation":[{"name":"Cardiology, Pohang Semyeong Christianity 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