Nicoll Rachel, Zhao Ying, Wiklund Urban, Diederichsen Axel, Mickley Hans, Ovrehus Kristian, Zamorano Jose, Gueret Pascal, Schmermund Axel, Maffei Erica, Cademartiri Filippo, Budoff Matt, Henein Michael
Department of Public Health and Clinical Medicine, Umeå University and Heart Centre, Umeå, Sweden.
Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
J Diabetes Complications. 2017 Jul;31(7):1096-1102. doi: 10.1016/j.jdiacomp.2017.03.013. Epub 2017 Mar 31.
Although much has been written about the conventional cardiovascular risk factor correlates of the extent of coronary artery calcification (CAC), few studies have been carried out on symptomatic patients. This paper assesses the potential ability of risk factors to associate with an increasing CAC score.
From the European Calcific Coronary Artery Disease (Euro-CCAD) cohort, we retrospectively investigated 6309 symptomatic patients, 62% male, from Denmark, France, Germany, Italy, Spain and the USA. All had conventional cardiovascular risk factor assessment and CT scanning for CAC scoring.
Among all patients, male sex (OR = 4.85, p<0.001) and diabetes (OR = 2.36, p<0.001) were the most important risk factors of CAC extent, with age, hypertension, dyslipidemia and smoking also showing a relationship. Among patients with CAC, age, diabetes, hypertension and dyslipidemia were associated with an increasing CAC score in males and females, with diabetes being the strongest dichotomous risk factor (p<0.001 for both). These results were echoed in quantile regression, where diabetes was consistently the most important correlate with CAC extent in every quantile in both males and females. To a lesser extent, hypertension and dyslipidemia were also associated in the high CAC quantiles and the low CAC quantiles respectively.
In addition to age and male sex in the total population, diabetes is the most important correlate of CAC extent in both sexes.
尽管已有大量关于冠状动脉钙化（CAC）程度与传统心血管危险因素相关性的文献，但针对有症状患者的研究却很少。本文评估了危险因素与CAC评分增加之间的潜在关联能力。
我们从欧洲钙化性冠状动脉疾病（Euro-CCAD）队列中，回顾性研究了来自丹麦、法国、德国、意大利、西班牙和美国的6309例有症状患者，其中62%为男性。所有患者均进行了传统心血管危险因素评估以及用于CAC评分的CT扫描。
在所有患者中，男性（OR = 4.85，p<0.001）和糖尿病（OR = 2.36，p<0.001）是CAC程度最重要的危险因素，年龄、高血压、血脂异常和吸烟也显示出相关性。在有CAC的患者中，年龄、糖尿病、高血压和血脂异常与男性和女性的CAC评分增加均相关，其中糖尿病是最强的二分危险因素（男女均p<0.001）。这些结果在分位数回归中得到印证，在男性和女性的每个分位数中，糖尿病始终是与CAC程度最重要的关联因素。在较小程度上，高血压和血脂异常分别在高CAC分位数和低CAC分位数中也存在关联。
除了总体人群中的年龄和男性性别外，糖尿病是男女CAC程度最重要的关联因素。
