Coronary artery calcium, exercise tests, and CHD outcome

描述(由申请者提供)：我们的目标是评估冠状动脉钙(CAC)和运动试验(心肺功能[CRF]和异常运动试验)作为预测冠心病(CHD)的指标。我们还将有近5,000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病的预测指标。最后，我们将评估腹部肥胖(内脏脂肪和皮下脂肪)作为冠心病和糖尿病的预测因子。CAC和腹部肥胖症将通过EBT进行评估，运动试验结果将来自最大跑台运动试验。研究小组大约有35,000名妇女(12,250人)和22,750名男子(n=22,750人)，他们在1995-2002年间至少接受过一次EBT评估。随访期平均为3.1年，其中女性38,548人。和70,654人。在研究结束时进行观察。主要结果是合并致命性和非致命性CHD(ML、致命性CHD和血管重建术)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，以及906例糖尿病病例。次要结果(预期事件数)包括全因死亡(424例)和中风(318例)。如上所述，所有参与者都将患有CAC、腹部肥胖症和结局确定。这项研究的另一个优势是超过1.9万名参与者接受了全面的医学评估。这项检查提供了一个广泛的数据库，包括病史、健康习惯、体检和临床变量，包括血压、胆固醇、高密度脂蛋白胆固醇、甘油三酯、血糖以及休息和运动心电图。我们将确定病史或测量的CHD传统危险因素是否会影响初次暴露与CHD或糖尿病之间的关联。这个独特的数据库使我们能够调查1)CAC作为冠状动脉解剖受损指标的疾病结局，2)作为冠状动脉生理受损指标的最大运动试验结果，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，以及这些指标的组合与冠心病发病的关系。这项研究将对初次接触作为冠心病和糖尿病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.