Taylor Allen J, Wu Holly, Bindeman Jody, Bauer Kelly, Byrd Carole, O'Malley Patrick G, Feuerstein Irwin
Department of Medicine and Cardiology Service, Walter Reed Army Medical Center, Washington, DC, USA.
J Cardiovasc Comput Tomogr. 2009 Mar-Apr;3(2):71-7. doi: 10.1016/j.jcct.2008.12.009. Epub 2009 Jan 9.
Although African Americans have a lower prevalence and extent of coronary artery calcium (CAC) than whites, the relationship between ethnicity and CAC progression is unknown. In a prospective rescan substudy of the Prospective Army Coronary Calcium (PACC) Project, we evaluated ethnic differences in the rates of CAC progression over 4 years.
Two hundred healthy male PACC Project participants (age, 47.8 +/- 2.8 years) with CAC on their original scan volunteered to undergo a second electron beam tomography (EBT) scan and cardiovascular risk factor assessment (interscan interval, 4.3 +/- 1.2 y). All results were independently examined and blinded to baseline data. A change in CAC score >or=15%/y was defined as clinically significant progression. The relationship between race and CAC progression was evaluated with multivariable linear and logistic regression models controlling for age and other cardiovascular risk factors.
African Americans had significantly lower baseline CAC scores (34.3 vs 101.5; P = 0.004); lower follow-up CAC scores (56.6 vs 180.6; P = 0.001); and worse cardiovascular risk profiles. The annualized CAC progression rate was not significantly related to race in the multivariable linear regression model controlling for age, the Framingham risk score, and other cardiovascular risk factors. Significant CAC progression occurred in 43.5% of all participants. The incidence of significant progression of CAC for African American and white men was similar (53.1% vs 52.4%; P = 0.94), even when controlling for age, the Framingham risk score, and other cardiovascular risk factors.
Although African American men have less CAC than white men, CAC progression occurs at a comparable rate over 4 years.
尽管非裔美国人冠状动脉钙化（CAC）的患病率和程度低于白人，但种族与CAC进展之间的关系尚不清楚。在一项前瞻性军队冠状动脉钙化（PACC）项目的前瞻性重新扫描子研究中，我们评估了4年期间CAC进展率的种族差异。
200名在初次扫描时发现有CAC的健康男性PACC项目参与者（年龄47.8±2.8岁）自愿接受第二次电子束断层扫描（EBT）和心血管危险因素评估（两次扫描间隔时间为4.3±1.2年）。所有结果均独立检查，且对基线数据设盲。CAC评分变化≥15%/年被定义为具有临床意义的进展。通过控制年龄和其他心血管危险因素的多变量线性和逻辑回归模型评估种族与CAC进展之间的关系。
非裔美国人的基线CAC评分显著较低（34.3对101.5；P = 0.004）；随访时的CAC评分较低（56.6对180.6；P = 0.001）；心血管危险因素状况较差。在控制年龄、弗雷明汉风险评分和其他心血管危险因素的多变量线性回归模型中，CAC的年化进展率与种族无显著相关性。所有参与者中有43.5%发生了显著的CAC进展。非裔美国男性和白人男性CAC显著进展的发生率相似（53.1%对52.4%；P = 0.94），即使在控制年龄、弗雷明汉风险评分和其他心血管危险因素时也是如此。
尽管非裔美国男性的CAC比白人男性少，但在4年期间CAC进展的速率相当。
