Differentiation of severe coronary artery calcification in the Multi-Ethnic Study of Atherosclerosis

被引：38

作者：

Coylewright, Megan ^{[1
]}

Rice, Kenneth ^{[2
]}

Budoff, Matthew J. ^{[3
]}

Blumenthal, Roger S. ^{[4
]}

Greenland, Philip ^{[5
]}

Kronmal, Richard ^{[6
]}

Barr, R. Graham ^{[7
]}

Burke, Gregory L. ^{[8
]}

Tracy, Russell ^{[9
]}

Post, Wendy S. ^{[4
,10
]}

机构：

[1] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA

[2] Univ Washington, Dept Biostat, Seattle, WA 98195 USA

[3] Harbor UCLA Med Ctr, Los Angeles Biomed Res Inst, Div Cardiol, Torrance, CA 90509 USA

[4] Johns Hopkins Univ, Sch Med, Johns Hopkins Ciccarone Ctr Prevent Heart Dis, Baltimore, MD USA

[5] Northwestern Univ, Feinberg Sch Med, Dept Prevent Med, Chicago, IL 60611 USA

[6] Univ Washington, Collaborat Hlth Studies Coordinating Ctr, Seattle, WA 98195 USA

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

[8] Wake Forest Univ, Bowman Gray Sch Med, Div Publ Hlth Sci, Winston Salem, NC USA

[9] Univ Vermont, Colchester Res Facil, Dept Pathol, Colchester, VT USA

[10] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA

来源：

ATHEROSCLEROSIS | 2011年 / 219卷 / 02期

基金：

美国国家卫生研究院;

关键词：

Atherosclerosis; Imaging; Epidemiology; HEART-DISEASE PREDICTION; COMPUTED-TOMOGRAPHY; SUBCLINICAL ATHEROSCLEROSIS; ETHNIC-GROUPS; CARDIAC CT; CALCIUM; RISK; MESA; EVENTS; QUANTIFICATION;

D O I：

10.1016/j.atherosclerosis.2011.08.038

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Background: Coronary artery calcium (CAC) scores predict coronary heart disease (CHD) risk. Little is known, however, about the distinctive risk among asymptomatic individuals with very high CAC (>= 1000) compared to high CAC (400-999). Methods and results: We compared CHD risk factors and event rates between participants with very high CAC (n = 257) and high CAC (n = 420) among adults free of clinical CHD in the Multi-Ethnic Study of Atherosclerosis (MESA). CAC was measured at baseline, and participants were followed for a median of 68 months. Very high CAC (>= 1000), compared to high CAC (400-999), was associated with male gender (OR 3.10, p < 0.001) and older age (OR 1.42 per 10 year increase, p < 0.001). Chronic kidney disease (CKD) was associated with very high CAC (OR 1.66, p = 0.009) with a greater prevalence of moderate CKD (GFR 30-59) in the >= 1000 group (25% vs. 18%). Those with very high CAC were more likely to develop angina (adjusted HR 1.72 [95% CI 1.03-2.90], p = 0.04), but not more likely to experience myocardial infarction, resuscitated cardiac arrest, or CHD death (adjusted HR 1.17, [95% CI 0.64-2.12] p = 0.61) compared to high CAC. Total CHD event rates were greater for very high CAC (3.7 per 100 person-years) compared to high CAC (2.6 per 100 person-years). Conclusions: Both high and very high CAC are associated with an elevated risk of CHD events in those without symptomatic CHD at baseline; however, very high CAC is associated with an increased risk of angina, but not CHD death or MI, compared to high CAC. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

引用

页码：616 / 622

页数：7

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