University of Mississippi Medical Center, Jackson, MS, USA.
Int J Cardiovasc Imaging. 2013 Apr;29(4):891-7. doi: 10.1007/s10554-012-0145-y. Epub 2012 Oct 31.
To examine the associations of peripheral atherosclerosis, assessed by the ABI at baseline with the extent of AAC and with CAC measured by MDCT at follow-up examination in the Jackson Heart Study cohort. Four categories of ABI: <0.90, 0.90-0.99, 1.00-1.39; >1.40. Presence of CAC/AAC was defined as scoring above the 75th percentile among participants with non-zero CT calcium scores. We conducted multivariable log-binomial models for this analysis examining the relationship between ABI and the presence of CAC or AAC using normal ABI (1.0 ≤ ABI ≤ 1.39) as the reference group. We estimated prevalence ratios adjusted for age, smoking, HTN, DM, BMI, LDL, HDL, CRP, systolic and diastolic blood pressure, and use of lipid-lowering medication. There were 2,398 patients in this analysis (women: 65 %, average age 55 years). AAC scores were not significantly different between sex. CAC scores were significantly higher in males than females regardless of ABI groups. The prevalence of significant AAC was 1.7 times higher for ABI < 0.90 (PR = 1.70; 95 % CI = 1.26-2.28; p = 0.0004) and 1.57 times higher for ABI 0.90-0.99 (PR = 1.57; 95 % CI = 1.20-2.03; p = 0.0008) than the normal ABI; AAC prevalence did not differ between subjects with ABI > 1.40 compared to those with normal ABI. The prevalence of the significant CAC was higher for ABI < 0.90 (PR = 1.55; 95 % CI = 1.12-2.14; p value = 0.0081) and ABI 0.90-0.99 (PR = 1.60; 95 % CI = 1.05-2.46; p = 0.0402) compared to normal ABI; CAC prevalence did not differ between subjects with ABI > 1.40 compared to those with normal ABI. Lower ABI was significantly associated with the extent of AAC and CAC in this cohort. ABI can provide clinicians with an inexpensive additional tool to assess vascular health and cardiovascular risk without exposing the patient to ionizing radiation.
为了研究基线时通过 ABI 评估的外周动脉粥样硬化与随访时通过 MDCT 测量的 AAC 和 CAC 程度之间的关联，我们在 Jackson Heart 研究队列中进行了此项研究。ABI 分为以下 4 个类别：<0.90、0.90-0.99、1.00-1.39、>1.40。存在 CAC/AAC 定义为在非零 CT 钙评分参与者中得分高于第 75 百分位。我们使用正常 ABI（1.0≤ABI≤1.39）作为参考组，进行了多变量对数二项式模型分析，以检查 ABI 与 CAC 或 AAC 存在之间的关系。在这项分析中，共有 2398 名患者（女性占 65%，平均年龄 55 岁）。AAC 评分在性别之间没有显著差异。无论 ABI 组如何，男性的 CAC 评分均显著高于女性。ABI<0.90 的患者中，显著 AAC 的患病率是正常 ABI 的 1.7 倍（PR=1.70；95%CI=1.26-2.28；p=0.0004），ABI 为 0.90-0.99 的患者为 1.57 倍（PR=1.57；95%CI=1.20-2.03；p=0.0008）；ABI>1.40 的患者与正常 ABI 相比，AAC 的患病率无差异。ABI<0.90 的患者中，显著 CAC 的患病率更高（PR=1.55；95%CI=1.12-2.14；p 值=0.0081），ABI 为 0.90-0.99 的患者（PR=1.60；95%CI=1.05-2.46；p=0.0402）高于正常 ABI；ABI>1.40 的患者与正常 ABI 相比，CAC 的患病率无差异。在该队列中，较低的 ABI 与 AAC 和 CAC 的程度显著相关。ABI 可以为临床医生提供一种廉价的额外工具，在不使患者暴露于电离辐射的情况下评估血管健康和心血管风险。
