Coronary Artery Calcium Progression and Atrial Fibrillation: The Multi-Ethnic Study of Atherosclerosis.

作者信息

O'Neal Wesley T, Efird Jimmy T, Qureshi Waqas T, Yeboah Joseph, Alonso Alvaro, Heckbert Susan R, Nazarian Saman, Soliman Elsayed Z

机构信息

From the Department of Internal Medicine (W.T.O.), Department of Internal Medicine, Section on Cardiology (W.T.Q., J.Y., E.Z.S.), and Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention (E.Z.S.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Cardiovascular Sciences, East Carolina Heart Institute, Brody School of Medicine, East Carolina University, Greenville, NC (J.T.E.); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (A.A.); Cardiovascular Health Research Unit and Department of Epidemiology, University of Washington, Seattle (S.R.H.); and Departments of Medicine and Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (S.N.).

出版信息

Circ Cardiovasc Imaging. 2015 Dec;8(12). doi: 10.1161/CIRCIMAGING.115.003786.

DOI:10.1161/CIRCIMAGING.115.003786

PMID:26659375

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4681308/

Abstract

BACKGROUND

Coronary artery calcium (CAC) measured at a single time point has been associated with an increased risk for atrial fibrillation (AF). It is unknown whether CAC progression over time carries a similar risk.

METHODS AND RESULTS

This analysis included 5612 participants (mean age: 62±10; 52% women; 39% whites; 27% blacks; 20% Hispanics; 12% Chinese Americans) from the Multi-Ethnic Study of Atherosclerosis. Phantom-adjusted Agatston scores for baseline and follow-up measurements were used to compute change in CAC per year (≤0, 1-100, 101-300, and >300 U/year). AF was ascertained by review of hospital discharge records and from Medicare claims data through December 31, 2010. Cox regression was used to compute hazard ratios (HR) and 95% confidence intervals (CI) for the association between CAC progression and AF. Over a median follow-up of 5.6 years (25th, 75th percentiles=5.1, 6.8), a total of 203 (3.6%) incident AF cases were detected. Any CAC progression (>0/year) was associated with an increased risk for AF (HR=1.55, 95% CI=1.10, 2.19), and the risk increased with higher levels of CAC progression (≤0/year: HR=1.0 [reference]; 1-100/year: HR=1.47, 95% CI=1.03, 2.09; 101-300/year: HR=1.92, 95%CI=1.15, 3.20; >300/year: HR=3.23, 95%CI=1.48, 7.05). An interaction was observed by age with the association of CAC progression with AF being stronger for younger (<61 years: HR=3.53, 95% CI=1.29, 9.69) compared with older (≥61 years: HR=1.42, 95% CI=0.99, 2.04) participants (P interaction=0.037).