Carotid Intima-Media Thickness Score, Positive Coronary Artery Calcium Score, and Incident Coronary Heart Disease: The Multi-Ethnic Study of Atherosclerosis.
Carotid Intima-Media Thickness Score, Positive Coronary Artery Calcium Score, and Incident Coronary Heart Disease: The Multi-Ethnic Study of Atherosclerosis.
复制标题
颈动脉内膜中层厚度评分、冠状动脉钙化评分阳性和冠心病发病率：动脉粥样硬化的多种族研究。
DOI：
10.1161/jaha.116.004612
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发表时间：
2017-01-21
影响因子：
5.4
通讯作者：
O'Leary DH
中科院分区：
文献类型：
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作者：
Polak JF;Szklo M;O'Leary DH
颈总动脉和颈内动脉内膜-中膜厚度（IMT）与冠心病（CHD）相关，且随年龄增长而增加。使用年龄、性别和种族/民族IMT百分位数与Framingham危险因素和冠状动脉钙评分相结合，可以改善冠心病的预测。我们在多种族动脉粥样硬化研究（MESA）中研究了这些可能性，这是一项多种族队列研究，包括白人、中国人、黑人和西班牙人。IMT数据是在45至84岁的年龄范围内获得的。计算每个MESA参与者的颈总动脉和颈内动脉IMT、性别和种族/民族特定的规范性值，并将其合并为IMT评分。将IMT评分添加到(1)包含Framingham危险因素、性别、种族/民族的基础模型和(2)添加冠状动脉钙的基础模型中，生成以冠心病为结局的多变量Cox‐比例风险模型和logistic回归模型。估计了哈勒尔C -统计量和曲线下面积。中位随访时间为10.2年（四分位数范围：9.7至10.7年），其中429例首次发生冠心病。平均年龄为62.1岁，52.6%的参与者为女性。IMT评分使曲线下基底面积从0.7210增加到0.7396 (P=0.0008)，加入阳性冠状动脉钙评分使模型从0.7627增加到0.7714 （P=0.02）。基于规范数据的颈动脉IMT评分逐渐增加Framingham危险因素和阳性钙评分，在不同种族的队列中预测首次冠心病。
Common carotid artery and internal carotid artery intima‐media thicknesses (IMT) are associated with coronary heart disease (CHD) and increase with age. Using age, sex, and race/ethnicity IMT percentiles may improve CHD prediction when added to Framingham risk factors and coronary artery calcium score. We study these possibilities in the Multi‐Ethnic Study of Atherosclerosis (MESA), a multi‐ethnic cohort of whites, Chinese, blacks, and Hispanics. IMT data were acquired in the age range 45 to 84 years. Common carotid artery and internal carotid artery IMT, sex, and race/ethnic specific normative values were calculated for each MESA participant and combined as an IMT score. Multivariable Cox‐proportional hazards models and logistic regression models were generated with CHD as outcome adding the IMT score to (1) a base model with Framingham risk factors, sex, race/ethnicity and (2) the base model with coronary artery calcium added. Harrell's C‐statistics and area under the curve were estimated. Median follow‐up was 10.2 years (interquartile range: 9.7, 10.7 years) with 429 first‐time CHD events. Mean age was 62.1 years and 52.6% of participants were women. IMT score increased the base area under the curve from 0.7210 to 0.7396 (P=0.0008) and with positive coronary artery calcium score added to the model, from 0.7627 to 0.7714 (P=0.02). A carotid IMT score based on normative data incrementally adds to Framingham risk factors and a positive calcium score in predicting first‐time CHD in an ethnically diverse cohort.