Arterial Age as a Function of Coronary Artery Calcium (from the Multi-Ethnic Study of Atherosclerosis [MESA])
Arterial Age as a Function of Coronary Artery Calcium (from the Multi-Ethnic Study of Atherosclerosis [MESA])
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DOI：
10.1016/j.amjcard.2008.08.031
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发表时间：
2009-01-01
影响因子：
2.8
通讯作者：
Kronmal, Richard A.
中科院分区：
文献类型：
--
作者：
McClelland, Robyn L.;Nasir, Khurram;Kronmal, Richard A.
有人提出，冠状动脉钙（CAC）可用于估计成人的动脉年龄。支持这一概念的是，心血管风险评估中使用的实际年龄是动脉粥样硬化负担的替代指标。该测量可以为患者提供更易于理解的 CAC 评分版本（例如，“您今年 55 岁，但您的动脉与 65 岁的动脉年龄更一致”）。本研究的目的是描述一种通过将估计的冠心病 (CHD) 风险等同于观察年龄和 CAC 来计算动脉年龄的方法。动脉年龄就是 CAC 的风险当量。使用的数据来自动脉粥样硬化多种族研究 (MESA)，这是一项对 6,814 名没有临床心血管疾病的参与者进行的队列研究，平均随访时间为 4 年。估计的动脉年龄是通过对数转换的 CAC 的简单线性函数获得的。在控制年龄和动脉年龄的冠心病事件风险模型中，只有动脉年龄具有显着性，这表明在控制动脉年龄后观察到的年龄并不能提供额外的信息。使用该动脉年龄计算的弗雷明汉风险比基于观察年龄的弗雷明汉风险更能预测短期冠状动脉事件（基于观察年龄的弗雷明汉风险的受试者工作特征曲线下面积为 0.75，使用动脉年龄计算的弗雷明汉风险为 0.79，p = 0.006）。总之，动脉年龄可以方便地将 CAC 从 Agatston 单位转换为患者和治疗医生更容易理解的量表。 (C) 2009 Elsevier Inc.（Am J Cardiol 2009；103:59-63）
It has been proposed that coronary artery calcium (CAC) can be used to estimate arterial age in adults. Supporting this concept is that chronologic age, as used in cardiovascular risk assessment, is a surrogate for atherosclerotic burden. This measure can provide patients with a more understandable version of their CAC scores (e.g., "You are 55 years old, but your arteries are more consistent with an arterial age of 65 years"). The aim of this study was to describe a method of calculating arterial age by equating estimated coronary heart disease (CHD) risk for observed age and CAC. Arterial age is then the risk equivalent of CAC. Data from the Multi-Ethnic Study of Atherosclerosis (MESA), a cohort study of 6,814 participants free of clinical cardiovascular disease and followed for an average of 4 years, were used. Estimated arterial age was obtained as a simple linear function of log-transformed CAC. In a model for incident CHD risk controlling for age and arterial age, only arterial age was significant, indicating that observed age does not provide additional information after controlling for arterial age. Framingham risk calculated using this arterial age was more predictive of short-term incident coronary events than Framingham risk on the basis of observed age (area under the receiver-operating characteristic curve 0.75 for Framingham risk on the basis of observed age and 0.79 using arterial age, p = 0.006). In conclusion, arterial age provides a convenient transformation of CAC from Agatston units to a scale more easily appreciated by patients and treating physicians. (C) 2009 Elsevier Inc. (Am J Cardiol 2009;103:59-63)