Thromb Haemost 2022; 122(06): 1040-1046
DOI: 10.1055/s-0041-1736444
Atherosclerosis and Ischaemic Disease

Calcification Propensity in Serum and Cardiovascular Outcome in Peripheral Artery Disease

Marija Bojic
1   Division of Nephrology, Medicine III, Medical University of Vienna, Austria
Bernhard Bielesz
1   Division of Nephrology, Medicine III, Medical University of Vienna, Austria
Daniel Cejka
2   Department of Medicine III, Nephrology, Transplantation Medicine, Rheumatology, Geriatrics, Ordensklinikum Linz Elisabethinen, Linz, Austria
Gerit-Holger Schernthaner
3   Division of Angiology, Medicine II, Medical University of Vienna, Austria
3   Division of Angiology, Medicine II, Medical University of Vienna, Austria
› Author Affiliations
Funding The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: funding was provided by Medical University of Vienna, Vienna, Austria.


Peripheral artery disease (PAD) has been shown to be linked to elevated cardiovascular risk. The novel T50 test quantifies calcification propensity of serum and has been associated with cardiovascular events and mortality in patients with chronic kidney disease (CKD) and in the general population. This study investigated the association of calcification propensity measured by the T50 test in 287 patients with PAD without severe CKD. Major cardiovascular events (MACEs) including nonfatal stroke and nonfatal myocardial infarction and all-cause death (MACE + ) were evaluated after a median follow-up of 4 years and long-term cardiovascular and all-cause mortality after a median follow-up of 8.7 years by Kaplan–Meier and Cox regression analyses. Mean T50 time was 268 ± 63 minutes in the study cohort (age 69 ± 10 years, 32% women, 47% diabetes). Low T50 values that signify high calcification propensity were significantly associated with the occurrence of MACE+ (hazard ratio [HR]: 0.72; 95% confidence interval [CI]: 0.55–0.94). This association sustained multivariate adjustment for cardiovascular risk factors (CVRFs), Fontaine PAD stage, and prevalent media sclerosis (HR: 0.65; CI: 0.47–0.91). Cardiovascular mortality was significantly associated with T50 after multivariate adjustment for CVRF (HR: 0.72; CI 0.53–0.99), but not all-cause mortality (HR: 0.80; CI: 0.64–1.01). In conclusion, calcification propensity associates with MACE+ and cardiovascular mortality in patients with PAD.

Author Contributions

All authors contributed to: (1) substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, and (3) final approval of the version to be published.

Supplementary Material

Publication History

Received: 13 May 2021

Accepted: 26 August 2021

Article published online:
31 October 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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