Abdominal aortic calcific deposits are an important predictor of vascular morbidity and mortality
Abdominal aortic calcific deposits are an important predictor of vascular morbidity and mortality
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DOI：
10.1161/01.cir.103.11.1529
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发表时间：
2001-03-20
期刊：
影响因子：
37.8
通讯作者：
Cupples, LA
中科院分区：
文献类型：
--
作者：
Wilson, PWF;Kauppila, LI;Cupples, LA
背景：腹动脉钙化沉积对长时间随访期间预测心血管疾病（CVD）的影响值得进一步研究。方法和结果：对1967年至1989年随访的1049名男性和1466名女性（平均年龄61岁）进行腰椎侧位x线片研究，作为冠心病（CHD）、CVD和CVD死亡率的预测因子。根据严重程度的增加，使用先前验证的腹主动脉钙（AAC）评分量表对第一至第四腰椎的主动脉前壁和后壁钙化沉积进行分级，评分范围从0到24分。冠心病454例，心血管疾病709例，心血管疾病死亡365例。在调整年龄、吸烟、糖尿病、收缩压、左心室肥厚、体重指数、胆固醇和高密度脂蛋白胆固醇等因素后，采用比例风险logistic回归检验AAC与后期事件之间的关联。与AAC最低的各组比较，各组2（男性：RR， 1.33； 95%可信区间[CI]， 1.02至1.74；女性：RR， 1.25; 95% CI， 0.95至1.65）和各组3（男性：RR， 1.68; 95% CI， 1.25至2.27；女性：RR， 1.78; 95% CI， 1.33至2.38）的多因素年龄调整相对危险度（RR）增加。冠心病和心血管疾病死亡率也得到了类似的结果。结论：腰侧位x线片检测到的aac沉积物是临床下动脉粥样硬化疾病的标志，也是随后血管发病率和死亡率的独立预测因子。
Background-The impact of abdominal arterial calcific deposits on the prediction of cardiovascular disease (CVD) over a long follow-up interval deserves greater scrutiny.Methods and Results-Lateral lumbar radiographs were studied as a predictor of incident coronary heart disease (CHD), CVD, and CVD mortality in 1049 men and 1466 women (mean age, 61 years) who were followed from 1967 to 1989. Anterior and posterior wall calcific deposits in the aorta at the level of the first through fourth lumbar vertebrae were graded according to increasing severity using a previously validated rating scale for abdominal aortic calcium (AAC) that ranges from 0 to 24 points. There were 454 cases of CHD, 709 cases of CVD, and 365 CVD deaths. Proportional hazards logistic regression was used to test for associations between AAC and later events after adjustment for age, cigarette use, diabetes mellitus, systolic blood pressure, left ventricular hypertrophy, body mass index, cholesterol, and HDL cholesterol. In comparisons with the lowest AAC tertile, the multivariate age-adjusted relative risks (RR) for CVD were increased in tertile 2 (men: RR, 1.33; 95% confidence interval [CI], 1.02 to 1.74; women: RR, 1.25; 95% CI, 0.95 to 1.65) and tertile 3 (men: RR, 1.68; 95% CI, 1.25 to 2.27; women: RR, 1.78; 95% CI, 1.33 to 2.38). Similar results were obtained with CHD and CVD mortality.Conclusions-AAC deposits, detected by lateral lumbar radiograms, are a marker of subdinical atherosclerotic disease and an independent predictor of subsequent vascular morbidity and mortality.