{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:30:16Z","timestamp":1792132216267,"version":"4.4.0"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2026,4,7]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>There is limited evidence of the relationship between aortic and iliac calcification and aortic events (aortic dissection or aneurysm rupture) and major adverse limb events (MALEs; peripheral revascularization and lower limb amputation). The aim of this population-based prospective cohort study was to investigate the association of aortic and iliac calcifications with aortic events and MALEs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>All participants from the DANCAVAS (Danish Cardiovascular Screening) trials who received a full thoracoabdominal aortic computed tomography scan with recorded measurements of aortic and iliac calcification were included. The aorta and iliac artery calcifications were measured in a 5-segment model and categorized into quartiles, apart from the ascending aorta, which was categorized into 4 exposure groups, as the majority of participants had no calcification in the ascending aorta. The participants were followed from inclusion in the DANCAVAS trial until aortic events, MALE, death, or end of follow-up on May 1, 2025. We used a competing risk hazard regression model adjusted for demographics, cardiovascular risk factors, aortic diameter, and ankle-brachial index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>In total, 13 065 participants were included in this study (94% men; mean age, 67\u00b14 years). Participants were followed for a mean of 8 years, during which 42 experienced an aortic event, and 311 experienced a MALE. The analyses of the aortic event outcome showed significantly increased subdistribution hazard ratios (SHRs) when having calcification scores in the fourth group or quartile for the ascending and abdominal aorta (SHR, 3.06 [95% CI, 1.15\u20138.16]; SHR, 7.61 [95% CI, 1.44\u201340.22], respectively). Calcification scores in the fourth group or quartile were strongly associated with MALEs in all segments: ascending aorta (SHR, 2.20 (95% CI, 1.56\u20133.10]), aortic arch (SHR, 6.49 [95% CI, 3.10\u201313.56]), descending aorta (SHR, 2.43; [95% CI, 1.45\u20134.08]), abdominal aorta (SHR, 7.89 [2.95\u201321.15]), and iliac arteries (SHR, 13.52 [95% CI, 4.32\u201342.24]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Severe aortic and iliac calcification was associated with significantly higher risk of aortic events and MALEs, suggesting that quantifying aortic calcification may provide valuable prognostic information and potentially improve the risk stratification in patients with aortic aneurysm or peripheral artery disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.125.076240","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T10:01:16Z","timestamp":1772445676000},"page":"1026-1037","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Aortic and Iliac Calcifications as Predictors of Aortic Dissection, Aneurysm Rupture, and Peripheral Vascular Disease: A Prospective Cohort Study from the DANCAVAS Trials"],"prefix":"10.1161","volume":"153","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6414-0294","authenticated-orcid":true,"given":"Cecilie Skov","family":"Petersen","sequence":"first","affiliation":[{"name":"Departments of Cardiology (C.S.P., Z.K., S.H., M.S., A.C.P.D.), Odense University Hospital, Odense, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2768-8829","authenticated-orcid":true,"given":"Zuzanna","family":"Karon","sequence":"additional","affiliation":[{"name":"Departments of Cardiology (C.S.P., Z.K., S.H., M.S., A.C.P.D.), Odense University Hospital, Odense, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0037-8962","authenticated-orcid":true,"given":"Lasse M.","family":"Obel","sequence":"additional","affiliation":[{"name":"Cardiothoracic and Vascular Surgery (L.M.O., L.K., J.S.L.), Odense University Hospital, Odense, Denmark."},{"name":"Dr Obel's current affiliation: Biochemistry and Immunology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark (L.M.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7654-8492","authenticated-orcid":true,"given":"Selma","family":"Hasific","sequence":"additional","affiliation":[{"name":"Departments of Cardiology (C.S.P., Z.K., S.H., M.S., A.C.P.D.), Odense University Hospital, Odense, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4612-4338","authenticated-orcid":true,"given":"Anna","family":"Mejldal","sequence":"additional","affiliation":[{"name":"Clinical Research (A.M.), Odense University Hospital, Odense, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8048-9779","authenticated-orcid":true,"given":"Lytfi","family":"Krasniqi","sequence":"additional","affiliation":[{"name":"Cardiothoracic and Vascular Surgery (L.M.O., L.K., J.S.L.), Odense University Hospital, Odense, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2358-2776","authenticated-orcid":true,"given":"Mie","family":"Sch\u00e6ffer","sequence":"additional","affiliation":[{"name":"Departments of Cardiology (C.S.P., Z.K., S.H., M.S., A.C.P.D.), Odense University Hospital, Odense, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0252-6631","authenticated-orcid":true,"given":"Flemming H.","family":"Steffensen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Lillebaelt Hospital, Vejle, Denmark (F.H.S., M.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9215-9796","authenticated-orcid":true,"given":"Lars","family":"Frost","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Regional Hospital Central Jutland, Silkeborg, Denmark (L.F., G.U.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9976-9981","authenticated-orcid":true,"given":"Jess","family":"Lambrechtsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Svendborg Hospital, Svendborg, Denmark (J.L., K.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0212-394X","authenticated-orcid":true,"given":"Martin","family":"Busk","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Lillebaelt Hospital, Vejle, Denmark (F.H.S., M.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9323-7503","authenticated-orcid":true,"given":"Grazina","family":"Urbonaviciene","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Regional Hospital Central Jutland, Silkeborg, Denmark (L.F., G.U.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6214-8751","authenticated-orcid":true,"given":"Kenneth","family":"Egstrup","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Svendborg Hospital, Svendborg, Denmark (J.L., K.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7592-1256","authenticated-orcid":true,"given":"Marek","family":"Karon","sequence":"additional","affiliation":[{"name":"Department of Medicine, Nyk\u00f8bing Falster Hospital, Nyk\u00f8bing Falster, Denmark (M.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5795-4794","authenticated-orcid":true,"given":"Lars M.","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"Clinical Biochemistry and Pharmacology (L.M.R.), Odense University Hospital, Odense, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9536-4488","authenticated-orcid":true,"given":"Jes S.","family":"Lindholt","sequence":"additional","affiliation":[{"name":"Cardiothoracic and Vascular Surgery (L.M.O., L.K., J.S.L.), Odense University Hospital, Odense, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1285-4826","authenticated-orcid":true,"given":"Axel C.P.","family":"Diederichsen","sequence":"additional","affiliation":[{"name":"Departments of Cardiology (C.S.P., Z.K., S.H., M.S., A.C.P.D.), Odense University Hospital, Odense, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.122.061065"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.121.318535"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0003-3944(01)00541-7"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2010.03.028"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehae179"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2024.10.096"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001106"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32250-X"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000617"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/23969873241231702"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.110.208181"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.5551\/jat.44784"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2010.11.017"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.114.303268"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeu293"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/2047487313482281"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.115.003843"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.11135"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2208681"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000625"},{"key":"e_1_3_3_22_2","volume-title":"ASCVD: Stata module for computing ACC\/AHA 10-year risk for an initial hard atherosclerotic cardiovascular disease (ASCVD) event","author":"Linden A","year":"2023","unstructured":"Linden A. ASCVD: Stata module for computing ACC\/AHA 10-year risk for an initial hard atherosclerotic cardiovascular disease (ASCVD) event; Statistical Software Components S459229: Boston College Department of Economics; 2023."},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-014-9930-3"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-012817"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S471335"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(90)90282-t"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.02.015"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jey173"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.11.053"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmbbm.2014.11.005"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1159\/000358123"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0263881"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2013.09.006"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2017.06.086"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2024.07.041"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2018180562"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1038\/jhh.2009.42"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-007-9123-4"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2019.11.039"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeae103"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.121.320702"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1177\/1403494811401482"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-012832"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-015-1082-6"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.125.076240","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T18:00:26Z","timestamp":1775498426000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.125.076240"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,7]]},"references-count":43,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2026,4,7]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.125.076240"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.125.076240","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,7]]},"assertion":[{"value":"2025-07-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}