Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Risk Score in Young Adults Predicts Coronary Artery and Abdominal Aorta Calcium in Middle Age: The CARDIA Study.
Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Risk Score in Young Adults Predicts Coronary Artery and Abdominal Aorta Calcium in Middle Age: The CARDIA Study.
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DOI：
10.1161/circulationaha.115.018042
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发表时间：
2016-01-12
期刊：
影响因子：
37.8
通讯作者：
McMahan CA
中科院分区：
文献类型：
--
作者：
Gidding SS;Rana JS;Prendergast C;McGill H;Carr JJ;Liu K;Colangelo LA;Loria CM;Lima J;Terry JG;Reis JP;McMahan CA
我们探讨了青年动脉粥样硬化的病理生物学决定因素(PDAY)在18-30岁时测量的冠状动脉和腹部危险分数以及这些分数的变化是否比25年后测量的分数更能预测25年后评估的冠状动脉钙(CAC)和腹主动脉钙(AAC)。在青年冠状动脉风险发展研究中，3008名参与者从18-30岁开始，每隔5年测量一次风险评分成分。CAC和AAC的评估年龄为43-55岁。计算CAC/AAC存在和范围的优势比(OR)，每分高一分，并计算预测CAC/AAC的c-统计量。CAC患病率为28%，AAC患病率为53%。PDAY得分每高1分，使用基线得分比25年得分高出CAC的几率更高(OR 1.29[95%CI 1.25-1.33]vs 1.12[1.11-1.14])。对于AAC，0岁和25岁的OR值相似(1.29[1.24-1.34]比1.22[1.19-1.26])。C-统计量在第0年的CAC预测高于第25年(0.731比0.705)，但在AAC的第0和第25年相似(0.665比0.670)。CAC的ORS在基线时最高，而AAC的ORS在10岁时最高。包括PDAY评分的变化和基线评分改善了预测。动脉粥样硬化风险和在亚临床动脉粥样硬化成像前的青年时期评估的风险变化提供了对未来亚临床动脉粥样硬化的强有力的预测。CAC和AAC除了反映研究时测量的风险外，还反映了慢性风险暴露。
We explored whether, the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) coronary and abdominal risk scores measured at ages 18–30 years and changes in these scores would more strongly predict coronary artery calcium (CAC) and abdominal aortic calcium (AAC) assessed 25 years later, than scores measured 25 years later. In the Coronary Artery Risk Development in Young Adults study, 3008 participants had measurements of risk score components at 5 year intervals beginning at ages 18–30 years. CAC and AAC were assessed at age 43–55 years. Odds ratios (OR) for presence and extent of CAC/AAC per/point higher score and c-statistics for predicting CAC/AAC were calculated. Prevalence of CAC was 28% and AAC was 53%. For each one point higher PDAY score, odds of CAC were higher using baseline scores than year 25 scores (OR 1.29 [95% CI 1.25–1.33] vs 1.12 [1.11–1.14]). For AAC, ORs at years 0 and 25 were similar (1.29 [1.24–1.34] vs 1.22 [1.19 –1.26]). C-statistic for CAC prediction was higher at year 0 than year 25 (0.731 vs 0.705) but similar at years 0 and 25 for AAC (0.665 vs 0.670). ORs for CAC were highest at baseline, and for AAC, year 10. Including change in PDAY scores with baseline scores improved prediction. Atherosclerosis risk and change in risk assessed in young adulthood years prior to subclinical atherosclerosis imaging provide strong prediction of future subclinical atherosclerosis. CAC and AAC reflect chronic risk exposure in addition to risk measured at time of study.