New look at the power of zero coronary artery calcium (CAC) in Asian population: a systemic review and meta-analysis.

IF 2.1 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Cardiovascular diagnosis and therapy Pub Date : 2024-06-30 Epub Date: 2024-05-30 DOI:10.21037/cdt-23-474
Chien-Liang Chen, Yun-Ju Wu, Shu-Ching Yang, Fu-Zong Wu
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引用次数: 0

Abstract

Background: Numerous studies have validated a 5-year warranty period for heart health in Western populations with a coronary artery calcium (CAC) score of zero. While the calcium score is a crucial cardiovascular risk indicator, its interpretation in Asian populations remains unclear. This meta-analysis aimed to clarify the uncertainty surrounding the prevalence, warranty period, and prognostic implications of zero CAC scores in Asian populations. It also examined the impact of sex on subclinical CAC progression. While the calcium score is a crucial cardiovascular risk indicator, its interpretation in Asian populations remains unclear. The study aimed to shed light on these issues by exploring the specificities of subclinical CAC progression in the Asian context.

Methods: Our systematic literature search, from the study's inception to October 2023, targeted studies on subclinical CAC progression in the Asian population with a zero CAC score. We searched the Cochrane Library, and PubMed. The search terms included "zero score", "coronary calcification", "zero CAC score", and "CAC scan".

Results: We evaluated seven published studies through a meta-analysis and assessed the risk of bias using the Newcastle-Ottawa Scale (NOS). In this meta-analysis of three observational studies addressing zero CAC prevalence (n=7,661), the pooled prevalence of zero CAC scores in the Asian population was 18.2% [95% confidence interval (CI): 12.5-25.9%]. A significant difference in follow-up warranty period was observed between the CAC zero group and subclinical CAC progression group (mean difference, 1.26 years; 95% CI: 0.94-1.58; P<0.001). Furthermore, the conversion rate of subclinical CAC progression differed significantly between males and females (risk ratio, 2.37; 95% CI: 1.98-2.84; P<0.001). Analysis of four studies revealed a notable discrepancy in the major adverse cardiovascular event (MACE) rate between the CAC (-) and CAC (+) groups (risk ratio, 4.78; 95% CI: 2.21-10.36; P<0.001).

Conclusions: The meta-analysis of zero CAC scores in Asian populations suggested an 18.2% prevalence. A 5-year warranty period was noted, with heightened subclinical CAC progression likelihood after this duration. Additionally, sex-based differences were observed in subclinical CAC progression rates. These findings will provide clinical cardiovascular risk stratification for guiding gender-specific clinical decision-making in asymptomatic in Asian individuals.

亚洲人冠状动脉钙化(CAC)零功率新观察:系统回顾和荟萃分析。
背景:大量研究证实,在冠状动脉钙(CAC)评分为零的西方人群中,5 年的心脏健康保证期是有效的。虽然冠状动脉钙化评分是一项重要的心血管风险指标,但其在亚洲人群中的解释仍不明确。这项荟萃分析旨在澄清亚洲人群中 CAC 零分的患病率、保质期和预后影响方面的不确定性。它还研究了性别对亚临床 CAC 进展的影响。虽然钙评分是一项重要的心血管风险指标,但它在亚洲人群中的解释仍不明确。本研究旨在通过探讨亚临床 CAC 进展在亚洲的特殊性来揭示这些问题:我们的系统性文献检索从研究开始到 2023 年 10 月,针对 CAC 分数为零的亚洲人群中的亚临床 CAC 进展研究。我们检索了 Cochrane 图书馆和 PubMed。检索词包括 "零分"、"冠状动脉钙化"、"CAC 零分 "和 "CAC 扫描":我们通过荟萃分析评估了七项已发表的研究,并使用纽卡斯尔-渥太华量表(NOS)评估了偏倚风险。在这项针对 CAC 零患病率的三项观察性研究(n=7,661)的荟萃分析中,亚洲人群的 CAC 零评分汇总患病率为 18.2% [95% 置信区间 (CI):12.5-25.9%]。CAC零分组和亚临床CAC进展组的随访保证期存在明显差异(平均差异为1.26年;95% CI:0.94-1.58;PC结论:CAC零分组和亚临床CAC进展组的随访保证期存在明显差异(平均差异为1.26年;95% CI:0.94-1.58):对亚洲人群 CAC 零分的荟萃分析表明,CAC 零分的发生率为 18.2%。我们注意到,5 年的保质期过后,亚临床 CAC 进展的可能性增加。此外,亚临床 CAC 进展率还存在性别差异。这些发现将为临床心血管风险分层提供依据,从而指导亚洲无症状人群针对不同性别做出临床决策。
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来源期刊
Cardiovascular diagnosis and therapy
Cardiovascular diagnosis and therapy Medicine-Cardiology and Cardiovascular Medicine
CiteScore
4.90
自引率
4.20%
发文量
45
期刊介绍: The journal ''Cardiovascular Diagnosis and Therapy'' (Print ISSN: 2223-3652; Online ISSN: 2223-3660) accepts basic and clinical science submissions related to Cardiovascular Medicine and Surgery. The mission of the journal is the rapid exchange of scientific information between clinicians and scientists worldwide. To reach this goal, the journal will focus on novel media, using a web-based, digital format in addition to traditional print-version. This includes on-line submission, review, publication, and distribution. The digital format will also allow submission of extensive supporting visual material, both images and video. The website www.thecdt.org will serve as the central hub and also allow posting of comments and on-line discussion. The web-site of the journal will be linked to a number of international web-sites (e.g. www.dxy.cn), which will significantly expand the distribution of its contents.
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