Predictors of incident stroke among individuals without coronary artery calcification: A pooled cohort analysis from the Multi-Ethnic Study of Atherosclerosis, Jackson Heart Study, and Framingham Heart Study.
Aliza Hussain, Michelle C Johansen, Michael J Blaha, Mouaz H Al-Mallah, Miguel Cainzos-Achirica, Vijay Nambi, Jerome I Rotter, Xiuqing Guo, Jie Yao, Stephen S Rich, Jaideep Patel, John W McEvoy, Khurram Nasir, Rebecca Gottesman, Roger S Blumenthal, Christie M Ballantyne, Salim S Virani, Mahmoud Al Rifai
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引用次数: 0
Abstract
Introduction: The absence of coronary artery calcium (CAC = 0) is associated with low risk of stroke events; however, predictors of incident stroke among those with CAC = 0 are not known.
Methods: Individual participant-level data were pooled from three prospective cohorts (Multi-Ethnic Study of Atherosclerosis [MESA], Jackson Heart Study, and Framingham Heart Study). Multivariable-adjusted Cox proportional hazards models were used to study the association between cardiovascular risk factors and incident adjudicated stroke among individuals with CAC = 0 who were free of clinical atherosclerotic cardiovascular disease at baseline.
Results: Among 6180 participants (mean age 53 [SD 11] years, 62% women, and 44% White, 36% Black, and 20% other individuals), over a median (IQR) follow up of 15 (12-16) years, there were 122 strokes (95 ischemic, 27 hemorrhagic) with an overall unadjusted event rate of 2.0 per 1000 person-years. After multivariable adjustment, risk factors associated with overall stroke included (hazard ratio [95% CI]) systolic blood pressure (SBP): 1.19 (1.05-1.36) per 10-mmHg increase and carotid intima-media thickness (CIMT): 1.21 (1.04-1.42) per 0.1-mm increment. Current cigarette smoking: 2.68 (1.11-6.50), SBP: 1.23 (1.06-1.42) per 10-mmHg increase, and CIMT: 1.25 (1.04-1.49) per 0.1-mm increment were associated with ischemic stroke, whereas C-reactive protein was associated with hemorrhagic stroke risk (0.49, 0.25-0.93).
Conclusion: In a large cohort of individuals with CAC = 0, the rate for incident stroke was low (2.0 per 1000-person years) and was associated with modifiable risk factors.
期刊介绍：
The premier, ISI-ranked journal of vascular medicine. Integrates the latest research in vascular biology with advancements for the practice of vascular medicine and vascular surgery. It features original research and reviews on vascular biology, epidemiology, diagnosis, medical treatment and interventions for vascular disease. A member of the Committee on Publication Ethics (COPE)
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