The association of risk factors with arteriographically defined coronary artery disease: what is the appropriate control group?
The association of risk factors with arteriographically defined coronary artery disease: what is the appropriate control group?
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危险因素与动脉造影定义的冠状动脉疾病的关联：合适的对照组是什么？
DOI：
10.1093/oxfordjournals.aje.a114600
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发表时间：
1987
影响因子：
5
通讯作者：
Pearson,TA
中科院分区：
文献类型：
--
作者：
Fried,LP;Pearson,TA
尽管使用动脉造影来定义冠状动脉疾病被认为是确定危险因素与动脉粥样硬化之间关联的最佳方法，但动脉造影研究之间发现的关联强度差异很大。为了评估这种关联是否受到动脉造影定义无疾病的变化的影响，作者评估了接受冠状动脉造影的患者的一份样本。根据动脉粥样硬化程度（0-24、25-49和≥50%最大狭窄）确定特定危险因素的患病率，以及它们与冠状动脉疾病（≥50%狭窄）的关联，分别使用0-24或0-49%最大狭窄的人作为对照组。分析显示，在男性和女性中，危险因素的患病率随着动脉粥样硬化的加剧而增加，中度动脉粥样硬化患者与病例的相似性高于轻度动脉粥样硬化患者。动脉造影确定的冠状动脉疾病与年龄、高血压、糖尿病、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇、吸烟和家族史的关联强度通常与对照组允许的动脉粥样硬化程度成反比。这些发现表明，将患有中度、亚临床动脉粥样硬化的人纳入对照组可能会削弱对危险因素与动脉粥样硬化关联的流行病学理解。
Although the use of arteriography to define coronary artery disease is considered the optimal method for determining associations of risk factors with atherosclerosis, the strengths of associations found have varied greatly between arteriographic studies. To assess whether such associations are affected by changes in the arteriographic definition of absence of disease, the authors evaluated one sample of patients undergoing coronary arteriography. The prevalence of specific risk factors by the extent of atherosclerosis (0–24, 25–49, and ≥50% maximal stenosis) was determined, as were their associations with coronary artery disease (≥50% stenosis), using persons with 0–24 or 0–49% maximal stenosis, separately, as control groups. Among both males and females, analysis showed increased prevalence of risk factors with increasing atherosclerosis, with greater similarity of those who had moderate atherosclerosis to the cases than to those who had minimal atherosclerosis. The strength of association of arteriographically defined coronary disease with age, hypertension, diabetes, low and high density lipoprotein cholesterol, smoking, and family history generally varied inversely with the extent of atherosclerosis permitted within the control group. These findings indicate that epidemiologic understanding of associations of risk factors with atherosclerosis may be weakened by including persons with moderate, subclinical atherosclerosis within the control group.