Association between mitral annular calcium and carotid artery stenosis and role of age and gender.

It has been previously suggested that mitral annular calcium (MAC) can be simply considered as a form of atherosclerosis in the elderly.(1) Calcitic deposits in the mitral annular area are often observed only in populations that develop significant atherosclerosis. Several echocardiographic and angiographic studies in the past years confirmed this hypothesis, demonstrating a significant association between MAC and coronary artery disease,(2-4) aortic atheroma,(5) and peripheral arterial atherosclerotic disease.(6) With regard to the association between MAC and carotid artery disease, to our knowledge only I published study is available.(7) In that study, Adler et al(2) found a significantly higher prevalence of carotid artery stenosis in patients with MAC than in the control group. The association between MAC and carotid artery disease could partially explain the increased risk of stroke observed in patients with MAC.(8-10) The present study evaluates the extent of the association of MAC and carotid artery stenosis in an Italian population and assesses whether factors such as age and gender could play a specific role in this association.