Department of Anatomy and Imaging, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Department of Internal Medicine, School of Medicine and Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Am J Cardiol. 2019 Dec 1;124(11):1655-1661. doi: 10.1016/j.amjcard.2019.08.029. Epub 2019 Sep 6.
Thoracic aortic calcium (TAC) and coronary artery calcium (CAC) are associated with an increased risk of cardiovascular disease (CVD) and death. However, risk factors associated with arterial calcium may vary across vascular beds. We verified whether TAC is associated with the same risk factors as is CAC in adults without established CVD. Cross-sectional analysis including 2,433 participants (aged 38 to 78 years) of ELSA-Brasil cohort in Minas Gerais, Brazil. Nonenhanced ECG-gated multislice computed tomography were performed to detect calcium in the thoracic aorta and the coronaries (2015 to 2016). Multivariate logistic regression evaluated the associations of both TAC and CAC with CVD risk factors (smoking, body mass index, physical activity, alcohol intake, family history of CVD, low-density lipoprotein- and high-density lipoprotein-cholesterol, HbA1c, blood pressure, antidiabetic, antihypertensive, and lipid lowering medications). Overall prevalence of TAC and CAC were 69% and 43%, respectively. CAC prevalence was lower among women (31%) than men (56%) (Adjusted odds ratio [OR] 0.30; 0.24 to 0.38). After adjustments, black individuals were less likely to have any CAC as compared with whites (OR 0.63; 0.47 to 0.86). Neither sex, nor race/skin color were statistically associated with TAC. Use of antidiabetic medications remained associated with CAC (OR 1.80; 1.23 to 2.631.01), but not with TAC. All other risk factors, except education, alcohol, physical activity and HbA1c, persisted statistically associated with both TAC and CAC in the final analysis, with small differences in the magnitudes of the ORs. In conclusion, the only disagreements seen in the risk factors associated with CAC and TAC were sex, race/skin color, and use of antidiabetic medications.
胸主动脉钙 (TAC) 和冠状动脉钙 (CAC) 与心血管疾病 (CVD) 和死亡风险增加相关。然而，与动脉钙相关的危险因素可能因血管床而异。我们验证了在没有明确 CVD 的成年人中，TAC 是否与 CAC 具有相同的危险因素。巴西米纳斯吉拉斯州 ELSA-Brasil 队列的 2433 名参与者（年龄 38 至 78 岁）进行了横断面分析。进行非增强 ECG 门控多层计算机断层扫描以检测胸主动脉和冠状动脉中的钙（2015 年至 2016 年）。多变量逻辑回归评估了 TAC 和 CAC 与 CVD 危险因素（吸烟、体重指数、体力活动、饮酒、CVD 家族史、低密度脂蛋白和高密度脂蛋白胆固醇、HbA1c、血压、降糖、降压和降脂药物）的关联。TAC 和 CAC 的总体患病率分别为 69%和 43%。女性 CAC 的患病率（31%）低于男性（56%）（调整后的优势比 [OR] 0.30；0.24 至 0.38）。调整后，与白人相比，黑人发生任何 CAC 的可能性较小（OR 0.63；0.47 至 0.86）。性别和种族/肤色与 TAC 均无统计学关联。降糖药物的使用仍与 CAC 相关（OR 1.80；1.23 至 2.63）。在最终分析中，除了教育、酒精、体力活动和 HbA1c 外，所有其他危险因素与 TAC 和 CAC 均保持统计学相关，OR 值的大小略有差异。总之，与 CAC 和 TAC 相关的危险因素中唯一的分歧是性别、种族/肤色和降糖药物的使用。
