Strömberg Susanna, Stomby Andreas, Engvall Jan, Östgren Carl Johan
Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Råslätts vårdcentral, Region Jönköping County, Jönköping, Sweden.
Scand J Prim Health Care. 2025 Jun;43(2):455-462. doi: 10.1080/02813432.2025.2456948. Epub 2025 Jan 24.
To investigate the association between Systematic Coronary Risk Evaluation 2 (SCORE2) and subclinical damage in two vascular beds: atherosclerosis in the coronary arteries and aortic arterial stiffness, in a large population-based cohort without cardiovascular disease or diabetes.
A cross-sectional study based on Swedish CArdio Pulmonary bioImaging Study (SCAPIS) data. A population-based cohort of 3087 participants aged 50-64.
Pulse Wave Velocity (PWV) was measured, and aortic arterial stiffness was defined as PWV≥ 10 m/s. Coronary artery calcium score (CACS) was determined by coronary computed tomography and clinically significant coronary calcification was defined as CACS > 100.
The prevalence of arterial stiffness was 6.6% in the low-moderate SCORE2 risk group, 31.0% in the high-risk group, and 53.3% in the very high-risk group. The prevalence of coronary calcification was 4.5%, 18.5% 23.0%, respectively. There was a modest overlap between arterial stiffness and coronary calcification in all SCORE2 risk groups. When comparing the high SCORE2 risk group with the low-moderate risk group, the Odds ratio (OR) was 6.4, 95% confidence interval (CI 5.1-8.0) for arterial stiffness and 4.8 (CI 3.7-6.3) for coronary calcification. When comparing the very high SCORE2 risk group to the low-moderate group, the OR was 16.2 (CI 11.3-23.1) for arterial stiffness and 6.4 (CI 4.2-9.7) for coronary calcification.
Our study shows that high cardiovascular risk according to SCORE2 is associated with increased arterial stiffness and significant coronary calcification in a population without prevalent cardiovascular disease or diabetes. This knowledge can be useful in primary care, where SCORE2 is frequently used as a risk prediction tool. The modest overlap between arterial stiffness and coronary calcification suggests that CACS and PWV describe different types of vascular damage.
在一个无心血管疾病或糖尿病的大型人群队列中，研究系统性冠状动脉风险评估2（SCORE2）与两个血管床的亚临床损害之间的关联，这两个血管床分别为冠状动脉粥样硬化和主动脉僵硬度。
一项基于瑞典心肺生物成像研究（SCAPIS）数据的横断面研究。一个基于人群的队列，共3087名年龄在50 - 64岁的参与者。
脉搏波速度（PWV）被测量，主动脉僵硬度定义为PWV≥10 m/s。冠状动脉钙化积分（CACS）通过冠状动脉计算机断层扫描确定，临床显著冠状动脉钙化定义为CACS>100。
在低 - 中度SCORE2风险组中，动脉僵硬度的患病率为6.6%，高风险组为31.0%，极高风险组为53.3%。冠状动脉钙化的患病率分别为4.5%、18.5%、23.0%。在所有SCORE2风险组中，动脉僵硬度和冠状动脉钙化之间存在适度重叠。当将高SCORE2风险组与低 - 中度风险组进行比较时，动脉僵硬度的优势比（OR）为6.4，95%置信区间（CI 5.1 - 8.0），冠状动脉钙化为4.8（CI 3.7 - 6.3）。当将极高SCORE2风险组与低 - 中度组进行比较时，动脉僵硬度的OR为16.2（CI 11.3 - 23.1），冠状动脉钙化为6.4（CI 4.2 - 9.7）。
我们的研究表明，在无心血管疾病或糖尿病的人群中，根据SCORE2评估的高心血管风险与动脉僵硬度增加和显著冠状动脉钙化相关。这一知识在初级保健中可能有用，在初级保健中SCORE2经常被用作风险预测工具。动脉僵硬度和冠状动脉钙化之间的适度重叠表明CACS和PWV描述了不同类型的血管损伤。
