探讨一般健康相关问题与亚临床冠状动脉疾病之间的关系：一项普通人群的横断面研究。

Exploration of the relationship between general health-related problems and subclinical coronary artery disease: a cross-sectional study in a general population.

机构信息

Department of Radiology, University Medical Center Groningen, Groningen, The Netherlands.

Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, The Netherlands.

出版信息

BMJ Open. 2024 Oct 14;14(10):e079835. doi: 10.1136/bmjopen-2023-079835.

DOI:10.1136/bmjopen-2023-079835

PMID:39401960

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11474743/

Abstract

OBJECTIVE

To explore associations between general health-related problems and subclinical coronary artery disease (CAD), determined by CT coronary calcium score (CT-CCS), in a general population.

DESIGN

A cross-sectional design.

SETTING

This study was performed in a prospective population-based cohort, examining the health and health-related behaviour of individuals living in the Northern Netherlands.

PARTICIPANTS

The initial cohort comprised 6763 participants ≥45 years of age who underwent CT-scanning. Participants were included for the current analysis if they filled in three validated questionnaires (Symptomatic Checklist-90, Research and Development Survey-36 and Reviving the Early Diagnosis of CardioVascular Diseases questionnaire (RED-CVD)) and did not have a history of cardiovascular disease. The final analysis included 6530 participants.

PRIMARY OUTCOME MEASURE

Backward-stepwise and forward-stepwise logistic regression analyses were performed to determine associations between general health-related problems and subclinical CAD (CCS≥100 and ≥300).

RESULTS

The median age was 53 years (25th, 75th percentile: 48, 58); 57% were women. CRCS≥100 was found in 1236 (19%) participants, 437 (12%) in women and 799 (29%) men and CCS≥300 in 643 (9.9%) participants of which 180 (4.8%) were women and 463 (16.6%) men. In univariate analysis, in women the expectation of health to worsen (OR=1.13, 95% CI: 1.05 to 1.21), and in men reduced exercise intolerance (OR=1.14, 95% CI: 1.06 to 1.23) were associated with CCS≥100. The total RED-CVD score in women (OR=1.06, (95% CI: 1.05 to 1.08) and men (OR=1.07, 95% CI: 1.06 to 1.09), and in men also reduced exercise intolerance (OR=1.15, 95% CI: 1.06 to 1.25) and headache (OR=0.55, 95% CI: 0.38 to 0.79) were associated with CCS≥300. In multivariate analyses, only general health expectation in women was still significantly associated with subclinical CAD (CCS≥300) (OR=1.92, 95% CI: 1.56 to 2.37).

CONCLUSION

Only a few general health-related problems were associated with the presence of subclinical CAD in the general population, however, these problems showed no strong association. Therefore, using health-related symptoms does not seem useful to pre-select for CT-CCS.

TRIAL REGISTRATION NUMBER

CCMO Register, NL17981.042.07 and NL58592.042.16.

摘要

目的

在普通人群中，通过 CT 冠状动脉钙评分（CT-CCS），探讨一般健康相关问题与亚临床冠状动脉疾病（CAD）之间的关系。

设计

横断面设计。

地点

本研究在一项前瞻性人群队列研究中进行，该研究检查了居住在荷兰北部的个体的健康和健康相关行为。

参与者

最初的队列包括 6763 名≥45 岁的接受 CT 扫描的参与者。如果他们填写了三份经过验证的问卷（症状检查表-90、研究和发展调查-36 以及心血管疾病早期诊断恢复问卷（RED-CVD））并且没有心血管疾病史，则将参与者纳入当前分析。最终分析包括 6530 名参与者。

主要结局测量

采用向后逐步和向前逐步逻辑回归分析，确定一般健康相关问题与亚临床 CAD（CCS≥100 和≥300）之间的关系。

结果

中位年龄为 53 岁（25 百分位数，75 百分位数：48，58）；57%为女性。1236 名（19%）参与者的 CRCS≥100，437 名（12%）为女性，799 名（29%）为男性，CCS≥300 为 643 名（9.9%）参与者，其中 180 名（4.8%）为女性，463 名（16.6%）为男性。在单变量分析中，女性预期健康状况恶化（OR=1.13，95%CI：1.05 至 1.21），男性运动耐量降低（OR=1.14，95%CI：1.06 至 1.23）与 CCS≥100 相关。女性（OR=1.06，（95%CI：1.05 至 1.08）和男性（OR=1.07，95%CI：1.06 至 1.09）的 RED-CVD 总分，以及男性的运动耐量降低（OR=1.15，95%CI：1.06 至 1.25）和头痛（OR=0.55，95%CI：0.38 至 0.79）与 CCS≥300 相关。在多变量分析中，只有女性的一般健康预期与亚临床 CAD（CCS≥300）仍然显著相关（OR=1.92，95%CI：1.56 至 2.37）。