Osei Albert D, Uddin S M Iftekhar, Dzaye Omar, Achirica Miguel Cainzos, Dardari Zeina A, Obisesan Olufunmilayo H, Kianoush Sina, Mirbolouk Mohammadhassan, Orimoloye Olusola A, Shaw Leslee, Rumberger John A, Berman Daniel, Rozanski Alan, Miedema Michael D, Budoff Matthew J, Vasan Ramachandran S, Nasir Khurram, Blaha Michael J
Johns Hopkins University, Baltimore, MD, USA.
Yale University, New Haven, CT, USA.
Atherosclerosis. 2020 May;301:65-68. doi: 10.1016/j.atherosclerosis.2020.04.006. Epub 2020 Apr 9.
We sought to understand the risk factor correlates of very early coronary artery calcium (CAC), and the potential investigational value of CAC phenotyping in adults aged 20-30 years.
We studied all participants aged 20-30 years at baseline (N = 373) in the Coronary Artery Calcium Consortium, a large multi-center cohort study of patients aged 18 years or older without known atherosclerotic cardiovascular disease (ASCVD) at baseline, referred for CAC scoring for clinical risk stratification. We described the prevalence of CAC in men and women, the frequency of risk factors by the presence of CAC (CAC = 0 vs CAC >0), and assessed the association between traditional non-demographic CVD risk factors (hypertension, hyperlipidemia, smoking, family history of CHD, and diabetes) and prevalent CAC, using age- and sex-adjusted logistic regression models.
The mean age of the study participants was 27.5 ± 2.4 years; 324 (86.9%) had CAC = 0, and 49 (13.1%) had CAC >0. Among the 49 participants with CAC, 38 (77.6%) were men, and median CAC score was low at 4.6. In age- and sex-adjusted models, there was a graded increase in the odds of CAC >0 with increasing traditional cardiovascular disease (CVD) risk factor burden (p = 0.001 for linear trend). Participants with ≥3 traditional risk factors had a statistically significant higher odds of having prevalent CAC (OR 5.57, 95% CI; 1.82-17.03) compared to participants with no risk factors.
Our study demonstrates the non-negligible prevalence of CAC among very high-risk young US adults, reinforcing the critical importance of traditional risk factors in the earliest development of detectable subclinical ASCVD.
我们试图了解极早期冠状动脉钙化（CAC）的风险因素相关性，以及在20 - 30岁成年人中进行CAC表型分析的潜在研究价值。
我们研究了冠状动脉钙化联盟中所有基线年龄在20 - 30岁的参与者（N = 373），该联盟是一项针对18岁及以上、基线时无已知动脉粥样硬化性心血管疾病（ASCVD）的患者进行的大型多中心队列研究，这些患者因临床风险分层而接受CAC评分。我们描述了男性和女性中CAC的患病率、根据CAC情况（CAC = 0与CAC >0）划分的风险因素频率，并使用年龄和性别调整的逻辑回归模型评估传统非人口统计学CVD风险因素（高血压、高脂血症、吸烟、冠心病家族史和糖尿病）与现患CAC之间的关联。
研究参与者的平均年龄为27.5 ± 2.4岁；324人（86.9%）的CAC = 0，49人（13.1%）的CAC >0。在49名有CAC的参与者中，38人（77.6%）为男性，CAC中位数较低，为4.6。在年龄和性别调整模型中，随着传统心血管疾病（CVD）风险因素负担的增加，CAC >0的几率呈分级增加（线性趋势p = 0.001）。与无风险因素的参与者相比，有≥3种传统风险因素的参与者现患CAC的几率在统计学上显著更高（OR 5.57，95% CI；1.82 - 17.03）。
我们的研究表明，在美国极高危的年轻成年人中，CAC的患病率不可忽视，这强化了传统风险因素在可检测的亚临床ASCVD最早发展阶段的至关重要性。
