Division of General Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo, Brazil.
Am J Cardiol. 2024 Jun 15;221:29-36. doi: 10.1016/j.amjcard.2024.03.041. Epub 2024 Apr 16.
Atherosclerosis is an inflammatory disease. Coronary artery calcium (CAC) is a marker of atherosclerotic disease events and mortality risk. Increased GlycA, an emerging marker of inflammation, is associated with a higher risk for coronary artery disease (CAD). However, there is conflicting evidence on whether GlycA predicts subclinical CAD progression. We hypothesized that GlycA can predict subclinical CAC incidence/progression in healthy participants. We included 2,690 ELSA-Brasil cohort participants without cardiovascular/chronic inflammatory disease not receiving statin therapy who had GlycA levels measured and 2 interval CAC assessments between 2010 and 2018. Multivariable logistic and linear regression models were computed to evaluate GlycA as a predictor of CAC incidence and progression. CAC incidence required a baseline CAC of 0. CAC progression required a baseline CAC >0. The mean age of participants was 48.6 ± 7.7 years, 56.7% were women, and 54.6% and 16.1% (429 of 2,690) were White and Black, respectively. The mean CAC interscan period was 5.1 ± 0.9 years, the mean GlycA level was 414.7 ± 65 μmol/L, and the incidence of CAC was 13.1% (280 of 2,129). The GlycA level odds ratio for CAC incidence was 1.002 (95% confidence interval 1.0005 to 1.005, p = 0.016), adjusted for demographics, lifestyle, a family history of early CAD (≤60 years), lipids, and co-morbidities. The GlycA (≤p25 vs ≥p75) odds ratio for CAC progression (Berry definition) was 1.77 (95% confidence interval 1.07 to 2.96, p = 0.03) in a similar multivariable-adjusted model. Higher GlycA levels were associated with CAC incidence and progression in a healthy Brazilian cohort.
动脉粥样硬化是一种炎症性疾病。冠状动脉钙（CAC）是动脉粥样硬化疾病事件和死亡风险的标志物。新兴的炎症标志物 GlycA 升高与冠心病（CAD）风险增加相关。然而，关于 GlycA 是否预测亚临床 CAD 进展仍存在矛盾的证据。我们假设 GlycA 可以预测健康参与者的亚临床 CAC 发生率/进展。我们纳入了 2690 名没有心血管/慢性炎症性疾病且未接受他汀类药物治疗的 ELSA-Brasil 队列参与者，这些参与者的 GlycA 水平在 2010 年至 2018 年间进行了两次测量，并进行了两次 CAC 间隔评估。使用多变量逻辑和线性回归模型来评估 GlycA 作为 CAC 发生率和进展的预测因子。CAC 发生率需要基线 CAC 为 0。CAC 进展需要基线 CAC >0。参与者的平均年龄为 48.6±7.7 岁，56.7%为女性，54.6%和 16.1%（2690 名中的 429 名）分别为白人和黑人。两次 CAC 扫描之间的平均间隔时间为 5.1±0.9 年，平均 GlycA 水平为 414.7±65μmol/L，CAC 发生率为 13.1%（2129 名中的 280 名）。GlycA 水平与 CAC 发生率的比值比为 1.002（95%置信区间 1.0005 至 1.005，p=0.016），经调整后包括人口统计学、生活方式、早发 CAD（≤60 岁）家族史、血脂和合并症。在类似的多变量调整模型中，GlycA（≤p25 与≥p75）与 CAC 进展（Berry 定义）的比值比为 1.77（95%置信区间 1.07 至 2.96，p=0.03）。在一个健康的巴西队列中，较高的 GlycA 水平与 CAC 发生率和进展相关。
