Risk factor differences in calcified and noncalcified aortic plaque: the Framingham Heart Study.
Risk factor differences in calcified and noncalcified aortic plaque: the Framingham Heart Study.
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DOI：
10.1161/atvbaha.114.303600
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发表时间：
2014-07
期刊：
影响因子：
--
通讯作者：
O'Donnell CJ
中科院分区：
文献类型：
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作者：
Chuang ML;Gona P;Oyama-Manabe N;Manders ES;Salton CJ;Hoffmann U;Manning WJ;O'Donnell CJ
在社区居住的成年人中，通过心血管磁共振（CMR）（主要显示非钙化斑块）和非对比计算机断层扫描（CT）（最能描述钙化斑块）确定主动脉斑块（AP）的患病率和风险因素（RF）相关性。1016名FRA后代队列成员（64± 9岁，474名男性）接受了主动脉CMR和CT。AP的潜在RF（年龄;性;体重指数;血压; LDL和HDL胆固醇;空腹血糖; C-反应蛋白;通过CMR和CT比较了AP为零与非零的参与者之间的患病率（高血压、糖尿病、吸烟;使用抗高血压、糖尿病或降脂药物）。将两种成像方式差异达到p<0.05的候选RF输入多变量逻辑回归模型，调整年龄、性别和其他RF。计算AP的特定模式患病率的比值比。使用Tobit回归评估RF和AP连续测量之间的关联。CMR和CT AP的患病率分别为49%和82%。CMR和CT的AP负荷相关，r=0.28，p<0.0001。年龄增长和吸烟与CMR和CT显示的AP患病率相关。此外，CMR检测的AP患病率与女性性别和空腹血糖相关，CT检测的AP患病率与高血压治疗和不良血脂相关。经CMR和CT检查的AP均与吸烟和年龄增加相关，但钙化和非钙化AP的其他危险因素不同。CMR检测AP与CT检测AP对心血管事件的相对预测价值仍有待确定。
Determine the prevalence and risk factor (RF) correlates of aortic plaque (AP) detected by cardiovascular magnetic resonance (CMR), which mainly shows noncalcified plaques, and by noncontrast computed tomography (CT), which best depicts calcified plaques, in community-dwelling adults. 1016 Framingham Offspring cohort members (64±9y, 474 men) underwent CMR and CT of the aorta. Potential RFs for AP (age; sex; BMI; blood pressure; LDL and HDL cholesterol; fasting glucose; C-reactive protein; prevalent hypertension, diabetes, smoking; use of antihypertensive, diabetes or lipid-lowering drugs) were compared between participants with zero versus nonzero AP by CMR and by CT. Candidate RFs attaining p<0.05 for difference with either imaging modality were entered into multivariable logistic regression models adjusting for age, sex and other RFs. Odds ratios were calculated for modality-specific prevalence of AP. Associations between RFs and continuous measures of AP were assessed using Tobit regression. Prevalences of CMR and CT AP were 49% and 82% respectively. AP burdens by CMR and CT were correlated, r=0.28, p<0.0001. Increasing age and smoking were associated with prevalent AP by both CMR and CT. Additionally, prevalent AP by CMR was associated with female sex and fasting glucose, prevalent AP by CT with hypertension treatment and with adverse lipid profile. AP by CMR and CT are both associated with smoking and increasing age, but other risk factors differ between calcified and noncalcified AP. The relative predictive value of AP detected by CMR versus by CT for incident cardiovascular events remains to be determined.