Newman A B, Naydeck B, Sutton-Tyrrell K, Edmundowicz D, Gottdiener J, Kuller L H
University of Pittsburgh School of Medicine, Department of Medicine, PA, USA.
J Am Geriatr Soc. 2000 Mar;48(3):256-63. doi: 10.1111/j.1532-5415.2000.tb02643.x.
Coronary artery calcification (CAC) reflects the extent of coronary artery atherosclerosis. The extent of coronary artery calcification is not well described in older adults.
To determine the extent of CAC in older adults participating in a large population study of cardiovascular disease (CVD), especially those characterized as having minimal clinical or subclinical cardiovascular disease.
An observational epidemiologic study.
Participants in the Cardiovascular Health Study Cohort, mean age 78 years, who had electron beam computed tomography (EBT) scan of the heart (n = 133); included were 106 persons with no prior evidence of clinical or subclinical CVD.
Total CAC score was measured using cardiac EBT. Cardiovascular disease and risk factors, as well as carotid ultrasound, electrocardiogram, echocardiogram, and ankle-arm index, had been measured previously to define subclinical disease. Previous cerebral magnetic resonance imaging was also evaluated.
Overall, the CAC scores were higher in those with clinical cardiovascular disease or evidence of subclinical cardiovascular disease than in those with no evidence of disease. For the 106 participants without evidence of clinical or subclinical disease, the median score was 176, compared with 367 in those with subclinical disease and 923 in those with clinical CVD. Seventeen persons had scores of zero. There was little difference in risk factors across quartiles of CAC in the subgroup of 106 with prior characterization of minimal CVD despite the broad range of CAC scores. There was a higher proportion of those with white matter grade > or = 2 by magnetic resonance imaging among those with higher CAC scores (P = .025). Infarct-like lesions prevalence ranged from 12.5% in the lowest group to 47.1% in the highest CAC group (P = .019).
Older adults with evidence of clinical or subclinical CVD have higher total CAC scores. Though the extent of coronary artery calcification was lower in those with minimal evidence of CVD, the range was broad and not explained by CVD risk factors.
冠状动脉钙化（CAC）反映冠状动脉粥样硬化的程度。老年人冠状动脉钙化程度的描述尚不充分。
确定参与大型心血管疾病（CVD）人群研究的老年人中CAC的程度，尤其是那些临床或亚临床心血管疾病程度较轻的人群。
一项观察性流行病学研究。
心血管健康研究队列的参与者，平均年龄78岁，接受了心脏电子束计算机断层扫描（EBT）（n = 133）；其中106人之前无临床或亚临床CVD的证据。
使用心脏EBT测量总CAC评分。先前已测量心血管疾病及危险因素，以及颈动脉超声、心电图、超声心动图和踝臂指数，以定义亚临床疾病。还对先前的脑磁共振成像进行了评估。
总体而言，有临床心血管疾病或亚临床心血管疾病证据者的CAC评分高于无疾病证据者。对于106名无临床或亚临床疾病证据的参与者，中位数评分为176，亚临床疾病者为367，临床CVD者为923。17人评分为零。在106名先前被认定为CVD程度较轻的亚组中，尽管CAC评分范围广泛，但各四分位数的危险因素差异不大。CAC评分较高者中，磁共振成像显示白质分级≥2级的比例更高（P = 0.025）。梗死样病变患病率从最低组的12.5%到最高CAC组的47.1%不等（P = 0.019）。
有临床或亚临床CVD证据的老年人总CAC评分较高。尽管CVD证据较少者冠状动脉钙化程度较低，但范围较广，且不能用CVD危险因素来解释。
