Coronary artery calcium, exercise tests, and CHD outcome

描述（由申请人提供）：我们的目标是评估冠状动脉钙（CAC）和运动测试结果（心肺适能[CRF]和异常运动测试）作为冠心病（CHD）的预测因子。我们还将有近5000人接受2次电子束断层扫描（EBT），这将使我们能够评估CAC的变化作为冠心病发生的预测因素。最后，我们将评估腹部脂肪（内脏和皮下脂肪）作为冠心病和糖尿病的预测因子。CAC和腹部肥胖将通过EBT评估，运动测试结果将来自最大的跑步机运动测试。研究对象是大约35000名女性（n= 12250）和男性（n= 22750），他们在1995-2002年期间已经或将要进行至少一次EBT评估。随访时间平均为3.1年。，有38548名女性。70654人年。在研究结束时进行观察。主要结局是合并致死性和非致死性冠心病（Ml、致死性冠心病和血运重建术）和糖尿病。我们估计将有139例冠心病死亡，1183例非致命性冠心病事件和906例糖尿病。次要结局（预期事件数）包括全因死亡率（424）和中风（318）。如上所述，所有参与者将有CAC、腹部肥胖和结果确定。这项研究的另一个优势是，19 000多名参与者接受了全面的医疗评估。该检查提供了一个广泛的数据库，包括病史、健康习惯、体格检查和临床变量，包括血压、胆固醇、HDL-C、甘油三酯、血糖、静息和运动心电图。我们将确定病史或测量的冠心病传统危险因素是否影响初次暴露与冠心病或糖尿病之间的关系。这个独特的数据库使我们能够研究以下疾病结局的含义：1)CAC作为冠状动脉解剖受损的指标，2)最大运动试验结果作为冠状动脉生理学受损的指标，以及3)腹部肥胖的评估。我们将评估CAC、CRF、异常运动试验结果的独立预测价值，以及这些结果的组合与冠心病的关系。本研究将对原发性暴露作为冠心病和糖尿病的预测因子的作用做出重要贡献。以及对预防这些疾病的影响。

DESCRIPTION (provided by applicant): Our goal is to evaluate coronary artery calcium (CAC) and exercise test results (cardiorespiratory fitness [CRF] and abnormal exercise tests) as predictors of coronary heart disease (CHD). We also will have nearly 5,000 persons who received 2 electron beam tomography (EBT) scans, which will allow us to evaluate change in CAC as a predictor of incident CHD. Finally, we will evaluate abdominal adiposity (visceral and subcutaneous fat) as predictors of CHD and diabetes. CAC and abdominal adiposity will be assessed by EBT, and exercise test results will be derived from a maximal treadmill exercise test. The study group is approximately 35,000 women (n=12,250) and men (n=22,750) who had or will have had at least 1 EBT evaluation during 1995-2002. Follow-up will be for an average of 3.1 yrs., with 38,548 woman-yrs. and 70,654 man-yrs. of observation by the end of the study. Primary outcomes are combined fatal and nonfatal CHD (Ml, fatal CHD, and revascularization procedures) and diabetes. We estimate there will be 139 CHD deaths, 1183 nonfatal CHD events, and 906 cases of diabetes. Secondary outcomes (# of expected events) include all-cause mortality (424) and stroke (318). All participants will have CAC, abdominal adiposity, and outcome ascertainment, as mentioned above. An additional strength of the study is the more than 19,000 of the participants who received a comprehensive medical evaluation. This exam provides an extensive database of medical history, health habits, physical examination, and clinical variables including blood pressure, cholesterol, HDL-C, triglyceride, plasma glucose, and resting and exercise ECGs. We will determine if medical history or measured conventional risk factors for CHD affect the association between the primary exposures and CHD or diabetes. This unique database allows us to investigate the disease outcome implications of 1) CAC as an indicator of compromised coronary artery anatomy, 2) results from a maximal exercise test as an indicator of compromised coronary artery physiology, and 3) assessments of abdominal adiposity. We will evaluate the independent predictive value of CAC, CRF, abnormal exercise test results, and the combination of these in relation to incident CHD. This study will make important contributions as to the role of the primary exposures as predictors of CHD and diabetes. and implications for the prevention of these diseases.