Vascular calcifications as a marker of increased cardiovascular risk: a meta-analysis.
Vascular calcifications as a marker of increased cardiovascular risk: a meta-analysis.
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DOI：
10.2147/vhrm.s4822
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发表时间：
2009
影响因子：
2.9
通讯作者：
Kroon AA
中科院分区：
文献类型：
--
作者：
Rennenberg RJ;Kessels AG;Schurgers LJ;van Engelshoven JM;de Leeuw PW;Kroon AA
一些成像技术可以显示动脉壁或心脏瓣膜的钙化。许多研究表明，当钙化存在时，心血管疾病的风险增加。最近关于冠状动脉钙化和心血管风险的荟萃分析可能因适应症而混淆。因此，本荟萃分析进行了广泛的亚组分析，以评估在使用不同成像技术时发现任何动脉壁或心脏瓣膜钙化的总体心血管风险。对报告钙化和心血管终点的前瞻性研究进行了荟萃分析。选出了30篇文章。在平均随访10.1年后，218,080名受试者中钙化与无钙化的总比值比（95%可信区间[CI]）为：全因死亡率4.62 (CI 2.24至9.53)，心血管死亡率3.94 (CI 2.39至6.50)，冠状动脉事件3.74 (CI 2.56至5.45)，中风2.21 (CI 1.81至2.69)，任何心血管事件3.41 （CI 2.71至4.30）。异质性在很大程度上是由随访时间和成像技术的种类来解释的。终末期肾病患者的亚组分析显示，任何事件的优势比都要高得多，为6.22 （CI 2.73至14.14）。动脉壁出现钙化与死亡和心血管事件的风险增加3 - 4倍相关。由于研究的异质性，对汇总估计的解释必须谨慎。
Several imaging techniques may reveal calcification of the arterial wall or cardiac valves. Many studies indicate that the risk for cardiovascular disease is increased when calcification is present. Recent meta-analyses on coronary calcification and cardiovascular risk may be confounded by indication. Therefore, this meta-analysis was performed with extensive subgroup analysis to assess the overall cardiovascular risk of finding calcification in any arterial wall or cardiac valve when using different imaging techniques. A meta-analysis of prospective studies reporting calcifications and cardiovascular end-points was performed. Thirty articles were selected. The overall odds ratios (95% confidence interval [CI]) for calcifications versus no calcifications in 218,080 subjects after a mean follow-up of 10.1 years amounted to 4.62 (CI 2.24 to 9.53) for all cause mortality, 3.94 (CI 2.39 to 6.50) for cardiovascular mortality, 3.74 (CI 2.56 to 5.45) for coronary events, 2.21 (CI 1.81 to 2.69) for stroke, and 3.41 (CI 2.71 to 4.30) for any cardiovascular event. Heterogeneity was largely explained by length of follow up and sort of imaging technique. Subgroup analysis of patients with end stage renal disease revealed a much higher odds ratio for any event of 6.22 (CI 2.73 to 14.14). The presence of calcification in any arterial wall is associated with a 3–4-fold higher risk for mortality and cardiovascular events. Interpretation of the pooled estimates has to be done with caution because of heterogeneity across studies.