Progression of coronary calcification in healthy postmenopausal women

被引：12

作者：

Hsia J. ^{[1
]}

Klouj A. ^{[2
]}

Prasad A. ^{[1
]}

Burt J. ^{[1
]}

Adams-Campbell L.L. ^{[3
]}

Howard B.V. ^{[4
]}

机构：

[1] Department of Medicine, The George Washington University, Washington

[2] Biostatist. Ctr. Medical Center Unit, The George Washington University, Washington

[3] Howard University Cancer Center, Washington

[4] Medstar Research Institute, Hyattsville

来源：

BMC Cardiovascular Disorders | / 4卷 / 1期

关键词：

Coronary Artery Calcium Score; Calcium Score; Coronary Calcification; Agatston Score; Conventional Risk Factor;

D O I：

10.1186/1471-2261-4-21

中图分类号：

学科分类号：

摘要：

Background: Coronary artery calcium score incrementally improves coronary risk prediction beyond that provided by conventional risk factors. Limited information is available regarding rates of progression of coronary calcification in women, particularly those with baseline scores above zero. Further, determinants of progression of coronary artery calcification in women are not well understood. This study prospectively evaluated rates and determinants of progression of coronary artery calcium score in a group of healthy postmenopausal women. Methods: We determined coronary calcium score by computed tomography and recorded demographic, lifestyle and health characteristics of 914 postmenopausal women, a subset of those enrolled in the Women's Health Initiative Observational Study. The 305 women with calcium score ≥10 Agatston units at baseline were invited for repeat scan. This analysis includes the 94 women who underwent second scans. Results: Mean age of study participants was 65 ± 9 years (mean ± SD), body mass index was 26.1 ± 6.1 kg/m2, and baseline calcium score was 162 ± 220 Agatston units. Mean interval between scans was 3.3 ± 0.7 years. A wide range of changes in coronary calcium score was observed, from -53 to +452 Agatston units/year. Women with lower scores at baseline had smaller annual increases in absolute calcium score. Coronary calcium scores increased 11, 31 and 79 Agatston units/year among women with baseline calcium score in the lowest, middle and highest tertiles. In multivariate analysis, age was not an independent predictor of absolute change in coronary calcium score. Hydroxymethylglutaryl coenzyme A reductase inhibitor (statin) use at baseline was a negative predictor (p = 0.015), whereas baseline calcium score was a strong, positive predictor (p < 0.0001) of progression of coronary calcification. Conclusion: Among postmenopausal women with coronary calcium score ≥ 10 Agatston units, rates of change of coronary calcium score varied widely. In multivariate analysis, statin use was a negative independent determinant, whereas baseline calcium score was a strong positive predictor of annual change in coronary calcium score. © 2004 Hsia et al; licensee BioMed Central Ltd.

引用

页数：6

共 24 条

[1]

Pletcher M.J., Tice J.A., Pignone M., Browner W.S., Using the coronary artery calcium score to predict coronary heart disease events: A systematic review and meta-analysis, Arch. Intern. Med., 164, pp. 1285-1292, (2004)

[2]

Kondos G.T., Hoff J.A., Sevrukov A., Daviglus M.L., Garside D.B., Devries S.S., Chomka E.V., Liu K., Electron-Beam Tomography Coronary Artery Calcium and Cardiac Events. A 37-month Follow-Up of 5635 Initially Asymptomatic Low- to Intermediate-Risk Adults, Circulation, 107, pp. 2571-2576, (2003)

[3]

Greenland P., LaBree L., Azen S.P., Doherty T.M., Detrano R.C., Coronary Artery Calcium Score Combined With Framingham Score for Risk Prediction in Asymptomatic Individuals, JAMA, 291, pp. 210-215, (2004)

[4]

Schmermund A., Erbel R., Silber S., Age and Gender Distribution of Coronary Artery Calcium Measured by Four-Slice Computed Tomography in 2,030 Persons With no Symptoms of Coronary Artery Disease, Am. J. Cardiol., 90, pp. 168-173, (2002)

[5]

Mahoney L.T., Burns T.L., Stanford W., Thompson B.H., Witt J.D., Rost C.A., Lauer R.M., Coronary Risk Factors Measured in Childhood and Young Adult Life Are Associated With Coronary Artery Calcification in Young Adults: The Muscatine Study, JACC, 27, pp. 277-284, (1996)

[6]

Shemesh J., Apter S., Stolero D., Itzchak Y., Motro M., Annual Progression of Coronary Artery Calcium by Spiral Computed Tomography in Hypertensive Patients Without Myocardial Ischemia But With Prominent Atherosclerotic Risk Factors, in Patients With Previous Angina Pectoris or Healed Acute Myocardial Infarction, and in Patients With Coronary Events During Follow-Up, Am. J. Cardiol., 87, pp. 1395-1397, (2001)

[7]

Raggi P., Callister T.Q., Shaw L.J., Progression of Coronary Artery Calcium and Risk of First Myocardial Infarction in Patients Receiving Cholesterol-Lowering Therapy, Arterioscler. Thromb. Vasc. Biol., 24, pp. 1272-1277, (2004)

[8]

Tani T., Yamakami S., Matsushita T., Okamoto M., Toyama J., Fukutomi T., Itoh M., Comparison of Coronary Artery Calcium Progression of Electron Beam Computed Tomography and Angiographically Defined Progression, Am. J. Cardiol., 91, pp. 865-867, (2003)

[9]

Budoff M.J., Lane K.L., Bakhsheshi H., Mao S., Grassmann B.O., Friedman B.C., Brundage B.H., Rates of progression of coronary calcium by electron beam tomography, Am. J. Cardiol., 86, pp. 8-11, (2000)

[10]

Sutton-Tyrrell K., Kuller L.H., Edmundowicz D., Feldman A., Holubkov R., Givens L., Matthews K.A., Usefulness of Electron Beam Tomography to Detect Progression of Coronary and Aortic Calcium in Middle-Aged Women, Am. J. Cardiol., 87, pp. 560-564, (2001)

← 1 2 3 →