Differentiation of severe coronary artery calcification in the Multi-Ethnic Study of Atherosclerosis
Differentiation of severe coronary artery calcification in the Multi-Ethnic Study of Atherosclerosis
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DOI：
10.1016/j.atherosclerosis.2011.08.038
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发表时间：
2011-12-01
期刊：
影响因子：
5.3
通讯作者：
Post, Wendy S.
中科院分区：
文献类型：
--
作者：
Coylewright, Megan;Rice, Kenneth;Post, Wendy S.
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.
