Prevalence and Progression of Subclinical Atherosclerosis in Younger Adults With Low Short-Term but High Lifetime Estimated Risk For Cardiovascular Disease The Coronary Artery Risk Development in Young Adults Study and Multi-Ethnic Study of Atherosclerosis

被引：255

作者：

Berry, Jarett D. ^{[1
]}

Liu, Kiang ^{[2
,3
]}

Folsom, Aaron R. ^{[4
]}

Lewis, Cora E. ^{[5
]}

Carr, J. Jeffrey ^{[6
,7
]}

Polak, Joseph F. ^{[8
]}

Shea, Steven ^{[9
,10
]}

Sidney, Stephen ^{[11
]}

O'Leary, Daniel H. ^{[8
]}

Chan, Cheeling ^{[2
]}

Lloyd-Jones, Donald M. ^{[2
,3
]}

机构：

[1] UT SW Med Ctr, Dept Med, Dallas, TX USA

[2] Northwestern Univ, Dept Prevent Med, Chicago, IL 60611 USA

[3] Northwestern Univ, Dept Med, Chicago, IL 60611 USA

[4] Univ Minnesota, Div Epidemiol & Community Hlth, Minneapolis, MN USA

[5] Univ Alabama Birmingham, Dept Prevent Med, Birmingham, AL USA

[6] Wake Forest Univ, Sch Med, Div Publ Hlth Sci, Winston Salem, NC 27109 USA

[7] Wake Forest Univ, Dept Internal Med, Cardiol Sect, Winston Salem, NC 27109 USA

[8] Tufts Univ, Sch Med, Dept Radiol, Boston, MA 02111 USA

[9] Columbia Univ, Dept Med, New York, NY USA

[10] Columbia Univ, Dept Epidemiol, New York, NY USA

[11] Kaiser Permanente No Calif, Oakland, CA USA

来源：

CIRCULATION | 2009年 / 119卷 / 03期

关键词：

epidemiology; prevention; risk estimation; risk factors; HEART-DISEASE; MEDIA THICKNESS; FACTOR BURDEN; PREDICTION; CALCIFICATION; AMERICAN; CALCIUM; SCORE; CT; QUANTIFICATION;

D O I：

10.1161/CIRCULATIONAHA.108.800235

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Background-We hypothesized that individuals with low 10-year but high lifetime cardiovascular disease risk would have a greater burden of subclinical atherosclerosis than those with low 10-year but low lifetime risk. Methods and Results-We included 2988 individuals <= 50 years of age at examination year 15 from the Coronary Artery Risk Development in Young Adults (CARDIA) study and 1076 individuals <= 50 of age at study entry from the Multi-Ethnic Study of Atherosclerosis (MESA). The 10-year risk and lifetime risk for cardiovascular disease were estimated for each participant, permitting stratification into 3 groups: low 10-year (< 10%)/low lifetime (< 39%) risk, low 10-year (< 10%)/high lifetime risk (>= 39%), and high 10-year risk (>= 10%) or diagnosed diabetes mellitus. Baseline levels and change in levels of subclinical atherosclerosis (coronary artery calcium or carotid intima-media thickness) were compared across risk strata. Among participants with low 10-year risk (91% of all participants) in CARDIA, those with a high lifetime risk compared with low lifetime risk had significantly greater common (0.83 versus 0.80 mm in men; 0.79 versus 0.75 mm in women) and internal (0.85 versus 0.80 mm in men; 0.80 versus 0.76 mm in women) carotid intima-media thickness, higher coronary artery calcium prevalence (16.6% versus 9.8% in men; 7.1% versus 2.3% in women), and significantly greater incidence of coronary artery calcium progression (22.3% versus 15.4% in men; 8.7% versus 5.3% in women). Similar results were observed in MESA. Conclusions-Individuals with low 10-year but high lifetime risk have a greater subclinical disease burden and greater incidence of atherosclerotic progression compared with individuals with low 10-year and low lifetime risk, even at younger ages. (Circulation. 2009; 119: 382-389.)

引用

页码：382 / 389

页数：8

共 34 条

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QUANTIFICATION OF CORONARY-ARTERY CALCIUM USING ULTRAFAST COMPUTED-TOMOGRAPHY [J].