Why should mitral annulus gets calcified ? . Degenerative calcification can be benign in elderly . If it occurs prematurely (say < 55 years ) there is enough reasons to worry . This may represent a systemic vascular inflammation and is considered a surrogate marker for athero- vascular -sclerosis . A study from Cidar Sinai , Los angels has well documented the link way back in 2003 !
This is a large study involving 17 735 patients (who were investigated for symptoms of CAD ) were screened.
The incidence of MAC was high (As expected !)
- 35% > 65 years
- 5 % < 65 years
Angiography revealed more surprises .
- The incidence of angiographic CAD among those who had MAC and no MAC was 88% v68% respectively ,( p = 0.0004),
- Left main coronary artery disease was (14% 4%, p = 0.009)
- Triple vessel disease was (54% v33%, p = 0.002).
Image source S.Atar , Heart 2003 : 89, 161-164
Conclusion
This study concluded , CAD is more aggressive in patients with MAC. It can also be an independent predictor of high risk CAD .
Further Implications of MAC
- MAC is more common in women, especially diabetics .
- Degenerative Mitral regurgitation is common ,rarely mitral stenosis
- Recurrent VPDs and even trouble some mitral annular VT is possible
- Extensive calcific lesions in coronary artery is also reported with MAC.
Link between Stroke and MAC .
This was well proven by this paper published in NEJM in 1992.
Dr.S.Venkatesan MD 
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