Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, the Netherlands.
Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, the Netherlands; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
Atherosclerosis. 2022 May;348:44-50. doi: 10.1016/j.atherosclerosis.2022.03.025. Epub 2022 Mar 30.
We aimed to determine associations of plasma amyloid-β40 (Aβ40) with subclinical atherosclerosis and risk of atherosclerotic cardiovascular disease (ASCVD) in the general population.
Between 2002 and 2005, plasma Aβ40 was measured by single molecule array (SiMoA®) in 3879 participants of the population-based Rotterdam Study (mean age: 71 years, 61% female). Subclinical atherosclerosis was quantified as computed tomography-assessed calcification volumes. We determined the association of Aβ40 with calcification volumes and clinical ASCVD event risk, and repeated the analyses for ASCVD in a replication cohort of 1467 individuals.
Higher levels of Aβ40 were associated with increased volumes of calcification in the coronary arteries and to a lesser extent extracranial carotid arteries, independent of traditional cardiovascular risk factors. Of all 3879 participants, 748 developed ASCVD during a median 9.7 years of follow-up. In age- and sex-adjusted models, higher Aβ40 predisposed to a minor increase in ASCVD risk (HR [95%CI]: 1.11[1.02-1.21] per 1-SD increase in Aβ40), driven by coronary heart disease (HR: 1.17[1.05-1.29]) rather than stroke (HR: 1.04[0.93-1.16]). However, excess risk of clinical outcomes was largely explained by baseline differences in cardiovascular risk factors and attenuated after further adjustment (for ASCVD- HR: 1.05[0.96-1.15] and for CHD- HR: 1.08[0.96-1.20]). Results were similar in the replication cohort, with highest risk estimates for CHD (HR: 1.24[1.04-1.48]) in age- and sex-adjusted models, attenuated after adjustment for cardiovascular risk factors (HR: 1.15[0.96-1.39]).
In this population-based study, higher plasma amyloid-β40 is associated with subclinical atherosclerosis, but not risk of first-ever ASCVD after accounting for traditional cardiovascular risk factors.
我们旨在确定人群中血浆淀粉样蛋白-β40（Aβ40）与亚临床动脉粥样硬化及动脉粥样硬化性心血管疾病（ASCVD）风险的相关性。
在 2002 年至 2005 年间，基于人群的鹿特丹研究（平均年龄 71 岁，61%为女性）中 3879 名参与者采用单分子阵列（SiMoA®）测量了血浆 Aβ40。通过计算机断层扫描评估钙化容积来量化亚临床动脉粥样硬化。我们确定了 Aβ40 与钙化容积和临床 ASCVD 事件风险的相关性，并在 1467 名参与者的复制队列中重复了这些分析。
在调整了传统心血管危险因素后，较高的 Aβ40 水平与冠状动脉和颅外颈动脉的钙化容积增加有关，但其相关性较小。在所有 3879 名参与者中，748 名在中位 9.7 年的随访期间发生了 ASCVD。在年龄和性别调整模型中，较高的 Aβ40 使 ASCVD 风险略有增加（每增加 1-SD 的 Aβ40，风险比 [95%CI]：1.11[1.02-1.21]），这主要归因于冠心病（风险比：1.17[1.05-1.29]）而不是中风（风险比：1.04[0.93-1.16]）。然而，临床结局的额外风险主要由心血管危险因素的基线差异解释，并在进一步调整后减弱（ASCVD 的风险比：1.05[0.96-1.15]，CHD 的风险比：1.08[0.96-1.20]）。在复制队列中的结果相似，年龄和性别调整模型中 CHD 的风险估计值最高（风险比：1.24[1.04-1.48]），在调整心血管危险因素后减弱（风险比：1.15[0.96-1.39]）。
在这项基于人群的研究中，较高的血浆淀粉样蛋白-β40 与亚临床动脉粥样硬化相关，但在考虑传统心血管危险因素后，与首次 ASCVD 风险无关。
