Department of Cardiology and Vascular Medicine, West-German Heart and Vessel Center Essen, University Duisburg-Essen, Essen, Germany
Institute of Medical Informatics, Biometry, and Epidemiology, University Duisburg-Essen, Essen, Germany.
J Am Heart Assoc. 2017 Mar 30;6(4):e005093. doi: 10.1161/JAHA.116.005093.
Thoracic aortic calcification (TAC) and coronary artery calcification (CAC) are markers of subclinical atherosclerosis and are associated with incident major cardiovascular events. We investigated major determinants for incidence and progression of TAC and the association between TAC and CAC incidence and progression.
In a population-based cohort study, 3270 participants (aged 45-74 years, 53.1% women) received cardiac computed tomography at baseline and after a mean follow-up of 5.1±0.3 years for quantification of calcification of the ascending (ATAC) and descending thoracic aorta (DTAC) and CAC. Multivariable relative risk regression analysis was used to investigate associations of cardiovascular risk factors with incident TAC, of baseline TAC with incident CAC, and of baseline CAC with incident TAC. Of 1243 participants with baseline TAC of 0, 517 (41.6%) revealed incident TAC after 5 years. Incidence of descending TAC was higher (34.5%) than ascending TAC (23.3%). Incident TAC after 5 years was associated with age (relative risk 1.26 [95% CI 1.21-1.33], per 5 years), blood pressure (relative risk 1.06 [95% CI 1.03-1.10], per 10 mm Hg), low-density lipoprotein cholesterol (relative risk 1.08 [95% CI 1.04-1.12], per 20 mg/dL), and smoking (relative risk 1.28 [95% CI 1.07-1.53]). Among the 1185 participants without CAC at baseline, the risk of developing CAC was 28.3% when baseline TAC was present compared with 22.2% among those without baseline TAC (excess risk 6.1% [95% CI 1.2-11.0%]). The point estimate of excess risk for incident CAC was higher for ascending TAC (10.8% [95% CI 4.8-16.7%]) and low for descending TAC (1.8% [95% CI -3.2% to 6.7%]). Excess risk for developing ascending and descending TAC with present baseline CAC was 16.4% (95% CI 12.7-20.0%) and 15.6% (95% CI 10.8-20.4%), respectively.
TAC and CAC share similar major determinants for incident calcification. Participants with TAC, especially ascending TAC, are at elevated risk for development of CAC.
胸主动脉钙化（TAC）和冠状动脉钙化（CAC）是亚临床动脉粥样硬化的标志物，与主要心血管事件的发生有关。我们研究了 TAC 发生率和进展的主要决定因素，以及 TAC 与 CAC 发生率和进展之间的关系。
在一项基于人群的队列研究中，3270 名参与者（年龄 45-74 岁，53.1%为女性）在基线时接受了心脏计算机断层扫描，并在平均 5.1±0.3 年的随访后对升主动脉（ATAC）和降主动脉（DTAC）及 CAC 的钙化进行了定量分析。采用多变量相对风险回归分析来研究心血管危险因素与 TAC 发生率的关系，基线 TAC 与 CAC 发生率的关系，以及基线 CAC 与 TAC 发生率的关系。在基线 TAC 为 0 的 1243 名参与者中，有 517 名（41.6%）在 5 年后出现 TAC。降主动脉 TAC 的发生率（34.5%）高于升主动脉 TAC（23.3%）。5 年后新发 TAC 与年龄（相对风险 1.26 [95%CI 1.21-1.33]，每 5 年）、血压（相对风险 1.06 [95%CI 1.03-1.10]，每 10mmHg）、低密度脂蛋白胆固醇（相对风险 1.08 [95%CI 1.04-1.12]，每 20mg/dL）和吸烟（相对风险 1.28 [95%CI 1.07-1.53]）有关。在 1185 名基线无 CAC 的参与者中，与基线无 TAC 相比，基线有 TAC 者 CAC 的发病风险为 28.3%（超额风险 6.1% [95%CI 1.2-11.0%]）。升主动脉 TAC 的 CAC 发生率的估计超额风险较高（10.8% [95%CI 4.8-16.7%]），降主动脉 TAC 的 CAC 发生率的估计超额风险较低（1.8% [95%CI -3.2%至 6.7%]）。基线 CAC 存在时，ASC 和 DESC TAC 发生的超额风险分别为 16.4%（95%CI 12.7-20.0%）和 15.6%（95%CI 10.8-20.4%）。
TAC 和 CAC 具有相似的发生钙化的主要决定因素。有 TAC 的参与者，尤其是升主动脉 TAC，发生 CAC 的风险增加。
Zotero 插件