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腹主动脉钙化与全因死亡率及心血管疾病特异性死亡率的关联:前瞻性队列研究。

Association of the abdominal aortic calcification with all-cause and cardiovascular disease-specific mortality: Prospective cohort study.

作者信息

Sheng Chang, Cai Zhou, Yang Pu

机构信息

Department of Vascular Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China.

National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.

出版信息

PLoS One. 2025 Jan 16;20(1):e0314776. doi: 10.1371/journal.pone.0314776. eCollection 2025.

Abstract

BACKGROUND

Abdominal aortic calcification (AAC) is a prevalent form of vascular calcification associated with adverse cardiovascular outcomes. While previous studies on AAC and cardiovascular risk exist, many have limitations such as small sample sizes and limited clinical significance outcomes. This study aims to prospectively investigate the association between AAC and all-cause and cardiovascular disease (CVD)-specific mortality rates in a nationally representative sample of adults in the United States, using data from the National Health and Nutrition Examination Survey (NHANES).

METHODS

The study, conducted on NHANES participants aged 40 years or older during the 2013-2014 cycle, assessed AAC using the Kauppila scoring system. Demographic characteristics, mortality data, and comorbid factors such as age, gender, diabetes, and hypertension were considered. Statistical analyses, including weighted percentages, Kaplan-Meier survival curves, and multivariable Cox proportional hazards regression models, were employed to evaluate the associations between AAC and mortality risks.

RESULTS

After analyzing a final sample of 2717 participants, the study found a significant association between severe AAC (SAAC) and higher all-cause mortality risk (HR 1.70, 95% CI 1.17-2.48). The dose-response relationship indicated an increased risk with higher AAC scores. However, no independent association was observed between AAC and cardiovascular mortality. Stratified analysis revealed variations in the AAC-all-cause mortality association based on gender and hypertension.

CONCLUSION

This population-based study provides valuable insights into the prospective association between AAC and all-cause mortality, emphasizing the potential role of AAC assessment in identifying individuals at higher risk.

摘要

背景

腹主动脉钙化(AAC)是一种常见的血管钙化形式,与不良心血管结局相关。虽然此前已有关于AAC与心血管风险的研究,但许多研究存在局限性,如样本量小和临床意义结局有限。本研究旨在利用美国国家健康与营养检查调查(NHANES)的数据,对美国成年人的全国代表性样本进行前瞻性研究,以调查AAC与全因死亡率及心血管疾病(CVD)特异性死亡率之间的关联。

方法

该研究对2013 - 2014周期中年龄在40岁及以上的NHANES参与者进行,使用考皮拉评分系统评估AAC。考虑了人口统计学特征、死亡率数据以及年龄、性别、糖尿病和高血压等合并因素。采用统计分析方法,包括加权百分比、卡普兰 - 迈耶生存曲线和多变量Cox比例风险回归模型,来评估AAC与死亡风险之间的关联。

结果

在分析了2717名参与者的最终样本后,研究发现严重腹主动脉钙化(SAAC)与更高的全因死亡风险之间存在显著关联(风险比1.70,95%置信区间1.17 - 2.48)。剂量反应关系表明,AAC评分越高,风险越高。然而,未观察到AAC与心血管死亡率之间存在独立关联。分层分析揭示了基于性别和高血压的AAC与全因死亡率关联的差异。

结论

这项基于人群的研究为AAC与全因死亡率之间的前瞻性关联提供了有价值的见解,强调了AAC评估在识别高风险个体方面的潜在作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c96/11737679/59882cf2439d/pone.0314776.g001.jpg

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