Department of Cardiology, Odense University Hospital, Odense, Denmark
Department of Cardiology, Odense University Hospital, Odense, Denmark.
Heart. 2021 Oct;107(19):1536-1543. doi: 10.1136/heartjnl-2021-319023. Epub 2021 Aug 10.
OBJECTIVE: Aortic valve calcification (AVC) and coronary artery calcification (CAC) are predictors of cardiovascular disease (CVD), presumably sharing risk factors. Our objectives were to determine the prevalence and extent of AVC in a large population of men aged 60-74 years and to assess the association between AVC and cardiovascular risk factors including CAC and biomarkers. METHODS: Participants from the DANish CArdioVAscular Screening and intervention trial (DANCAVAS) with AVC and CAC scores and without previous valve replacement were included in the study. Calcification scores were calculated on non-contrast CT scans. Cardiovascular risk factors were self-reported, measured or both, and further explored using descriptive and regression analysis for AVC association. RESULTS: 14 073 men aged 60-74 years were included. The AVC scores ranged from 0 to 9067 AU, with a median AVC of 6 AU (IQR 0-82). In 8156 individuals (58.0%), the AVC score was >0 and 215 (1.5%) had an AVC score ≥1200. In the regression analysis, all cardiovascular risk factors were associated with AVC; however, after inclusion of CAC ≥400, only age (ratio of expected counts (REC) 1.07 (95% CI 1.06 to 1.09)), hypertension (REC 1.24 (95% CI 1.09 to 1.41)), obesity (REC 1.34 (95% CI 1.20 to 1.50)), known CVD (REC 1.16 (95% CI 1.03 to 1.31)) and serum phosphate (REC 2.25 (95% CI 1.66 to 3.10) remained significantly associated, while smoking, diabetes, hyperlipidaemia, estimated glomerular filtration rate and serum calcium were not. CONCLUSIONS: AVC was prevalent in the general population of men aged 60-74 years and was significantly associated with all modifiable cardiovascular risk factors, but only selectively after adjustment for CAC ≥400 AU. TRIAL REGISTRATION NUMBER: NCT03946410 and ISRCTN12157806.
目的:主动脉瓣钙化(AVC)和冠状动脉钙化(CAC)是心血管疾病(CVD)的预测因子,推测它们具有共同的危险因素。我们的目的是确定 60-74 岁男性中大量人群的 AVC 患病率和严重程度,并评估 AVC 与心血管危险因素(包括 CAC 和生物标志物)之间的关系。
方法:纳入 DANish CArdioVAscular Screening and intervention trial(DANCAVAS)中具有 AVC 和 CAC 评分且无先前瓣膜置换的患者。使用非对比 CT 扫描计算钙化评分。心血管危险因素通过自我报告、测量或两者结合来评估,并进一步使用描述性和回归分析来探讨 AVC 与各因素之间的关系。
结果:共纳入 14073 名 60-74 岁男性。AVC 评分范围为 0-9067 AU,中位数为 6 AU(IQR 0-82)。在 8156 名(58.0%)患者中,AVC 评分>0,215 名(1.5%)患者的 AVC 评分≥1200。在回归分析中,所有心血管危险因素均与 AVC 相关;但纳入 CAC≥400 后,仅年龄(预期计数比(REC)1.07(95%CI 1.06-1.09))、高血压(REC 1.24(95%CI 1.09-1.41))、肥胖(REC 1.34(95%CI 1.20-1.50))、已知的 CVD(REC 1.16(95%CI 1.03-1.31))和血清磷酸盐(REC 2.25(95%CI 1.66-3.10))与 AVC 显著相关,而吸烟、糖尿病、高脂血症、估计肾小球滤过率和血清钙则无。
结论:60-74 岁男性人群中 AVC 患病率较高,与所有可改变的心血管危险因素显著相关,但仅在调整 CAC≥400 AU 后具有选择性。
临床试验注册号:NCT03946410 和 ISRCTN12157806。
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