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.
BMJ Open. 2024 Oct 14;14(10):e079835. doi: 10.1136/bmjopen-2023-079835.
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.
A cross-sectional design.
This study was performed in a prospective population-based cohort, examining the health and health-related behaviour of individuals living in the Northern Netherlands.
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.
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).
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).
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.
CCMO Register, NL17981.042.07 and NL58592.042.16.
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。
横断面设计。
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。
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。
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。
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）。
只有少数一般健康相关问题与普通人群中亚临床 CAD 的存在相关，但这些问题没有很强的相关性。因此，使用健康相关症状似乎无法用于 CT-CCS 的预选择。
CCMO 注册表，NL17981.042.07 和 NL58592.042.16。
