Incidence and progression of aortic valve calcium in the Multi-ethnic Study of Atherosclerosis (MESA).
Incidence and progression of aortic valve calcium in the Multi-ethnic Study of Atherosclerosis (MESA).
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DOI：
10.1016/j.amjcard.2009.10.071
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发表时间：
2010-03-01
影响因子：
2.8
通讯作者：
O'Brien, Kevin D.
中科院分区：
文献类型：
--
作者：
Owens, David S.;Katz, Ronit;Takasu, Junichiro;Kronmal, Richard;Budoff, Matthew J.;O'Brien, Kevin D.
主动脉瓣钙（AVC）在老年人中很常见，与动脉粥样硬化具有流行病学和组织病理学上的相似性。然而，前瞻性研究未能确定与事件（“新”）AVC或其进展有意义的风险关联。在这项研究中，使用Agatston方法，对5880名多种族动脉粥样硬化研究参与者（年龄45-84岁）的连续计算机断层扫描（CT）图像进行AVC量化。采用多变量反向选择模型来确定发生AVC和AVC进展的危险因素。平均随访2.4±0.9年，210例（4.0%）发生AVC。发病率（平均1.7% /年）随着年龄的增长而显著增加（p<0.001）。发生AVC的危险因素包括年龄、男性性别、BMI、当前吸烟、使用降脂和降压药物。在基线AVC患者中，AVC进展的中位速率为2 Agatston单位/年[IQR−21,37]。基线Agatston评分是病情进展的一个强有力的独立预测指标，特别是在基线钙评分高的患者中。总之，在这个种族多样化的临床前队列中，AVC的发生率与年龄显著相关。突发AVC风险与几个传统的心血管危险因素有关，特别是年龄、男性性别、BMI、当前吸烟以及降压和降脂药物的使用。AVC进展风险与男性性别和基线Agatston评分有关。需要进一步的研究来确定年龄和阶段特异性机制是否是AVC进展风险的基础。
Aortic valve calcium (AVC) is common among older adults and shares epidemiologic and histopathologic similarities to atherosclerosis. However, prospective studies have failed to identify meaningful risk-associations with incident (“new”) AVC or its progression. In this study, AVC was quantified from serial computed tomography (CT) images in 5,880 participants (aged 45–84 years) of the Multi-Ethnic Study of Atherosclerosis, using Agatston methodology. Multivariate backwards selection modeling was used to identify risk factors for incident AVC and AVC progression. During a mean follow up of 2.4±0.9 years, 210 subjects (4.0%) developed incident AVC. The incidence rate (mean 1.7 %/year) increased significantly with age (p<0.001). Risk factors for incident AVC included age, male gender, BMI, current smoking, and the use of lipid lowering and antihypertensive medications. Among those with AVC at baseline, the median rate of AVC progression was 2 Agatston units/year [IQR −21, 37]. Baseline Agatston score was a strong, independent predictor of progression, especially among those with high calcium scores at baseline. In conclusion, in this ethnically diverse, pre-clinical cohort, the rate of incident AVC a significantly with age. Incident AVC risk was associated with several traditional cardiovascular risk factors, specifically age, male gender, BMI, current smoking, and the use of both antihypertensive and lipid lowering medications. AVC progression risk was associated with male gender and the baseline Agatston score. Additional research is needed to determine if age- and stage-specific mechanisms underlie risk for AVC progression.
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影响因子：
2.8
作者：
Nassimiha, D;Aronow, WS;Goldman, ME
通讯作者：
Goldman, ME
DOI：
10.1016/s0735-1097(96)00563-3
发表时间：
1997-03-01
影响因子：
24
作者：
Stewart, BF;Siscovick, D;Otto, CM
通讯作者：
Otto, CM
影响因子：
5.3
作者：
Holvoet, Paul;Jenny, Nancy S.;Jacobs, David R.
通讯作者：
Jacobs, David R.
DOI：
10.1161/01.atv.0000255952.47980.c2
发表时间：
2007-03-01
影响因子：
8.7
作者：
Messika-Zeitoun, David;Bielak, Lawrence F.;Enriquez-Sarano, Maurice
通讯作者：
Enriquez-Sarano, Maurice
影响因子：
24
作者：
Novaro, Gian M.;Katz, Ronit;Griffin, Brian P.
通讯作者：
Griffin, Brian P.