Vázquez Mézquita Aldo Javier, Williams Michelle Claire, Choza Chenhalls Rafael, Guzmán Martínez Nancy Berenice, Chischistz Condey Ana Patricia, Acosta Falomir Maria José, Téliz Meneses Marco Antonio, Vázquez Sánchez María Nayeli
University/BHF Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK.
Department of Radiology and Molecular Imaging, Centro Médico ABC (The American British Cowdray Medical Center), Mexico City, Mexico.
SAGE Open Med. 2020 Jul 2;8:2050312120938233. doi: 10.1177/2050312120938233. eCollection 2020.
To establish tailored preventive treatment, we studied the ability of coronary artery calcium scoring to reclassify patients with intermediate cardiovascular risk and its association with additional risk factors in our Mexican preventive care center.
In this retrospective cohort study, we analyzed 520 asymptomatic patients from a Mexican primary prevention population between 2014 and 2018. Coronary artery calcium scoring, laboratory results, and anthropometric measurements (abdominal circumference and body mass index) were assessed. The Framingham risk score and American Heart Association/American College of Cardiology (AHA/ACC) atherosclerotic cardiovascular disease risk algorithm were calculated. Correlations between coronary artery calcium scoring, anthropometric measurements, and clinical cardiovascular risk scores were assessed. We assessed the ability of coronary artery calcium scoring to reclassify patients recommended for statin therapy compared with the cardiovascular risk scores.
Patients had a mean age of 67.5 years ( ± 9.8) and 294 subjects (56.5%) were male. Coronary artery calcium scoring has a positive correlation with age, AHA/ACC atherosclerotic cardiovascular disease risk algorithm, and Framingham risk score ( < 0.001 for all). Coronary artery calcium scoring was prevalent, occurring in 63.2% of patients with a median Agatston score of 22 with and interquartile range of 178. Male gender, older age, smoking habit, diabetes, and abdominal circumference were independent predictors of coronary artery calcium scoring ( < 0.001). Coronary artery calcium scoring downwardly reclassified 44.9% of patients in intermediate cardiovascular risk categories by the AHA/ACC atherosclerotic cardiovascular disease risk algorithm and 43.9% by the Framingham risk score. Coronary artery calcium scoring upwardly reclassified 46.8% of patients in intermediate risk categories by the AHA/ACC atherosclerotic cardiovascular disease risk algorithm and 56% by the Framingham risk score.
Coronary artery calcium scoring is prevalent in this Mexican primary prevention cohort and has the ability to reclassify a significant percentage of intermediate cardiovascular risk patients.
为制定个性化的预防性治疗方案，我们在墨西哥的预防保健中心研究了冠状动脉钙化评分对心血管风险处于中等水平患者进行重新分类的能力及其与其他风险因素的关联。
在这项回顾性队列研究中，我们分析了2014年至2018年间来自墨西哥初级预防人群的520例无症状患者。评估了冠状动脉钙化评分、实验室检查结果和人体测量指标（腹围和体重指数）。计算了弗雷明汉风险评分和美国心脏协会/美国心脏病学会（AHA/ACC）动脉粥样硬化性心血管疾病风险算法。评估了冠状动脉钙化评分、人体测量指标与临床心血管风险评分之间的相关性。与心血管风险评分相比，我们评估了冠状动脉钙化评分对推荐接受他汀类药物治疗的患者进行重新分类的能力。
患者的平均年龄为67.5岁（±9.8），294名受试者（56.5%）为男性。冠状动脉钙化评分与年龄、AHA/ACC动脉粥样硬化性心血管疾病风险算法和弗雷明汉风险评分呈正相关（均P<0.001）。冠状动脉钙化评分很常见，63.2%的患者存在该情况，阿加斯顿评分中位数为22，四分位间距为178。男性、年龄较大、吸烟习惯、糖尿病和腹围是冠状动脉钙化评分的独立预测因素（均P<0.001）。根据AHA/ACC动脉粥样硬化性心血管疾病风险算法，冠状动脉钙化评分使44.9%心血管风险处于中等水平的患者被向下重新分类，根据弗雷明汉风险评分，这一比例为43.9%。根据AHA/ACC动脉粥样硬化性心血管疾病风险算法，冠状动脉钙化评分使46.8%风险处于中等水平的患者被向上重新分类，根据弗雷明汉风险评分，这一比例为56%。
在这个墨西哥初级预防队列中，冠状动脉钙化评分很常见，并且有能力对相当比例的心血管风险处于中等水平的患者进行重新分类。
