Risk Factors for the Development and Progression of Thoracic Aorta Calcification: The Multi-Ethnic Study of Atherosclerosis.
Risk Factors for the Development and Progression of Thoracic Aorta Calcification: The Multi-Ethnic Study of Atherosclerosis.
复制标题
DOI：
10.1016/j.acra.2015.08.017
复制
发表时间：
2015-12
影响因子：
4.8
通讯作者：
Budoff MJ
中科院分区：
文献类型：
--
作者：
Youssef G;Guo M;McClelland RL;Shavelle DM;Nasir K;Rivera J;Carr JJ;Wong ND;Budoff MJ
血管钙化可独立预测心血管疾病（CVD），而计算机断层扫描（CT）不仅可用于评估和量化冠状动脉钙化，还可用于评估和量化胸主动脉钙化（TAC）。既往TAC进展报告仅限于透析和肾移植患者。这是第一项在入组时无临床明显CVD的大型多种族队列中评估TAC进展的研究。在6814名梅萨参与者中的5886名中获得了非造影剂增强心脏CT（平均年龄62岁; 48%为男性; 40%为白色，27%为黑人，21%为西班牙裔，12%为中国人）。获得基线和随访TAC评分。4308例（73%）受试者的基线TAC不可检测。平均随访时间为2.4±0.8年，在此期间，12%的患者发生了TAC。总发病率为4.8%/年，在不同性别和种族群体中，发病率随年龄的增长而增加;黑人的TAC发病率显著低于白人。调整随访时间后，回归分析显示年龄、收缩压、抗高血压药和吸烟与TAC事件相关。1578例（27%）参与者在基线时有TAC，平均每年TAC变化与基线年龄呈正相关。虽然总体中位数变化为32.9（-1.4，112.2）个阿加斯顿单位，但27%的人显示年度评分变化≥100，黑人在各族裔群体中的中位数最低; 22.7（-3，86.8）。年龄、收缩压、降脂药物、糖尿病和吸烟与TAC进展相关。在梅萨中，传统CV风险因素与TAC发生率和进展相关。黑人的发病率和中位数变化在各种族组中最低，与先前的冠状动脉钙化结果一致。
Vascular calcification independently predicts cardiovascular disease (CVD) and computed tomography (CT) is a useful tool to evaluate and quantify not only coronary but also thoracic aortic calcification (TAC). Previous TAC progression reports were limited to dialysis and renal transplant patients. This is the first study to evaluate TAC progression in a large multi-ethnic cohort without clinically evident CVD at entry. Non-contrast enhanced cardiac CT were obtained in 5886 of 6814 MESA participants (mean age 62 years; 48% males; 40% white, 27% Black, 21% Hispanic, 12% Chinese. Baseline and follow-up TAC scores were derived. 4308(73%) participants had no detectable baseline TAC. Mean follow-up duration was 2.4±0.8 years, during which 12% developed TAC. The overall incidence rate was 4.8%/year and was greater with age across gender and ethnic groups; TAC incidence was significantly lower in blacks than whites. After adjustment for follow-up duration, regression analyses showed age, systolic blood pressure, antihypertensives, and smoking were associated with incident TAC. 1578(27%) participants had TAC at baseline with a positive association between average annual TAC change and baseline age. While the overall median change was 32.9 (−1.4, 112.2) Agatston units, 27% showed an annual score change of ≥100 and blacks showed the lowest median across ethnic groups; 22.7 (−3, 86.8). Age, systolic BP, lipid-lowering medication, diabetes and smoking were associated with TAC progression. In MESA, traditional CV risk factors were related to both TAC incidence and progression. Blacks had the lowest incidence and median change across ethnic groups, consistent with previous findings for coronary calcification.