Association of Abdominal Aorta Calcium and Coronary Artery Calcium with Incident Cardiovascular and Coronary Heart Disease Events in Black and White Middle-Aged People: The Coronary Artery Risk Development in Young Adults Study.
Association of Abdominal Aorta Calcium and Coronary Artery Calcium with Incident Cardiovascular and Coronary Heart Disease Events in Black and White Middle-Aged People: The Coronary Artery Risk Development in Young Adults Study.
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DOI：
10.1161/jaha.121.023037
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发表时间：
2021-12-21
影响因子：
5.4
通讯作者：
Duprez, Daniel A.
中科院分区：
文献类型：
--
作者：
Jurgens, Paul T.;Carr, John J.;Terry, James G.;Rana, Jamal S.;Jacobs, David R., Jr.;Duprez, Daniel A.
关键词：
评估冠状动脉钙 (CAC) 是 AHA/ACC 针对 40 岁以上冠心病 (CHD) 中等风险人群的预防指南之一。为了研究增强的风险分层，我们研究了腹主动脉钙 (AAC) 相对于 CAC 对黑人和白人早期中年参与者心血管疾病 (CVD) 和 CHD 事件的预测价值，最初没有明显的 CVD。 CARDIA（年轻人冠状动脉风险发展）研究是一项多中心、基于社区的 CVD 风险纵向队列研究，在 2010-2011 年评估了 3011 名参与者的 CAC 和 AAC 评分，并随访至 2019 年发生的 CVD 和 CHD 事件。计算了总体和按种族的分布和预测。在 8 年的随访期间，发生了 106 起 CVD 事件（其中 55 起为 CHD）。 AAC 分数往往比 CAC 分数高得多。黑人女性的 AAC 分数高于白人女性。 CAC 预测 CVD 的 HR 为 1.77 (1.52–2.06)，与 AAC 类似，而只有 CAC 预测 CHD。调整危险因素和另一动脉床的钙含量后，CAC 与 CVD 的相关性独立于危险因素和 AAC，而 AAC 与 CVD 的相关性大大减弱。然而，当 CAC 为 0 时，AAC 预测会发生 CVD。预测不会因种族而异。 AAC 对 CVD 的预测几乎与 CAC 一样强，并且当它是偶然发现或未发现 CAC 时，作为诊断工具特别有用。
Assessing coronary artery calcium (CAC) is among AHA/ACC prevention guidelines for people at least 40 years old at intermediate risk for coronary heart disease (CHD). To study enhanced risk stratification, we investigated the predictive value of abdominal aorta calcium (AAC) relative to CAC for cardiovascular disease (CVD) and CHD events in Black and White early middle‐aged participants, initially free of overt CVD. In the CARDIA (Coronary Artery Risk Development in Young Adults) study, a multi‐center, community‐based, longitudinal cohort study of CVD risk, the CAC and AAC scores were assessed in 3011 participants in 2010–2011 with follow‐up until 2019 for incident CVD and CHD events. Distributions and predictions, overall and by race, were computed. During the 8‐year follow‐up, 106 incident CVD events (55 were CHD) occurred. AAC scores tended to be much higher than CAC scores. AAC scores were higher in Black women than in White women. CAC predicted CVD with HR 1.77 (1.52–2.06) and similarly for AAC, while only CAC predicted CHD. After adjustment for risk factors and calcium in the other arterial bed, the association of CAC with CVD was independent of risk factors and AAC, while the association of AAC with CVD was greatly attenuated. However, AAC predicted incident CVD when CAC was 0. Prediction did not vary by race. AAC predicted CVD nearly as strongly as CAC and could be especially useful as a diagnostic tool when it is an incidental finding or when no CAC is found.