Abdominal Compared With Coronary Artery Calcification and Incident Cardiovascular Events and Mortality in Black Adults.

IF 6.5 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Circulation: Cardiovascular Imaging Pub Date : 2024-12-01 Epub Date: 2024-11-27 DOI:10.1161/CIRCIMAGING.124.016775

Temidayo A Abe, Fengxia Yan, Titilope Olanipekun, Michael Blaha, Valery Effoe, Ndausung Udongwo, Robert J Mentz, Adebamike Oshunbade, James G Terry, Jalal K Ghali, Wondwosen K Yimer, Chukwuemezie Kamanu, Ifeoma Onuorah, Michael Hall, Anekwe Onwuanyi, Adolfo Correa, Melvin Echols

{"title":"Abdominal Compared With Coronary Artery Calcification and Incident Cardiovascular Events and Mortality in Black Adults.","authors":"Temidayo A Abe, Fengxia Yan, Titilope Olanipekun, Michael Blaha, Valery Effoe, Ndausung Udongwo, Robert J Mentz, Adebamike Oshunbade, James G Terry, Jalal K Ghali, Wondwosen K Yimer, Chukwuemezie Kamanu, Ifeoma Onuorah, Michael Hall, Anekwe Onwuanyi, Adolfo Correa, Melvin Echols","doi":"10.1161/CIRCIMAGING.124.016775","DOIUrl":null,"url":null,"abstract":"Background: Black adults show heightened cardiovascular risk compared with other groups despite comparable or lower coronary artery calcium (CAC) scores, indicating potential cardiovascular risk underestimation by CAC. Abdominal aortic calcification (AAC), preceding CAC, may predict cardiovascular events better in Black adults who are prone to early atherosclerotic cardiovascular disease and excess events at low CAC scores.Methods: We included 2551 participants from the JHS (Jackson Heart Study) visit 2 examination (2005-2008) without cardiovascular disease, followed through 2016. Cox regression estimated hazard ratios for incident cardiovascular events defined as a composite of myocardial infarction, stroke, heart failure, and all-cause mortality. The predictive value of CAC and AAC, when added to the American College of Cardiology/American Heart Association cardiovascular risk algorithm (pool cohort equation), was assessed.Results: Mean age was 57±10 years; 66% were women. Over a follow-up period of 12.6 years, 287 (11.3%) cardiovascular events and 360 (14.1%) mortality cases were observed. Adjusting for demographic and clinical variables, each 2-fold increase in CAC and AAC was associated with cardiovascular events (CAC: hazard ratio, 1.10 [95% CI, 1.06-1.13]; AAC: hazard ratio, 1.10 [95% CI, 1.06-1.13]) and all-cause mortality CAC: hazard ratio, 1.04 [95% CI, 1.01-1.08]; AAC: hazard ratio, 1.05 [95% CI, 1.01-1.08]). The incremental value of CAC (0.17 [95% CI, 0.08-0.23]) and AAC (0.15 [95% CI, 0.07-0.29]) to the pool cohort equation by net reclassification index was comparable. Notably, 45% of participants with 0 CAC showed some degree of AAC. Each 2-fold increase in AAC was associated with an increased risk of cardiovascular events (hazard ratio, 1.07 [95% CI, 1.01-1.19]) but not all-cause mortality among participants with 0 CAC.Conclusions: AAC is comparable to CAC in predicting cardiovascular events and all-cause mortality among Black adults, potentially valuable when CAC is absent.","PeriodicalId":10202,"journal":{"name":"Circulation: Cardiovascular Imaging","volume":" ","pages":"e016775"},"PeriodicalIF":6.5000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Circulation: Cardiovascular Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1161/CIRCIMAGING.124.016775","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/27 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Black adults show heightened cardiovascular risk compared with other groups despite comparable or lower coronary artery calcium (CAC) scores, indicating potential cardiovascular risk underestimation by CAC. Abdominal aortic calcification (AAC), preceding CAC, may predict cardiovascular events better in Black adults who are prone to early atherosclerotic cardiovascular disease and excess events at low CAC scores.

Methods: We included 2551 participants from the JHS (Jackson Heart Study) visit 2 examination (2005-2008) without cardiovascular disease, followed through 2016. Cox regression estimated hazard ratios for incident cardiovascular events defined as a composite of myocardial infarction, stroke, heart failure, and all-cause mortality. The predictive value of CAC and AAC, when added to the American College of Cardiology/American Heart Association cardiovascular risk algorithm (pool cohort equation), was assessed.

Results: Mean age was 57±10 years; 66% were women. Over a follow-up period of 12.6 years, 287 (11.3%) cardiovascular events and 360 (14.1%) mortality cases were observed. Adjusting for demographic and clinical variables, each 2-fold increase in CAC and AAC was associated with cardiovascular events (CAC: hazard ratio, 1.10 [95% CI, 1.06-1.13]; AAC: hazard ratio, 1.10 [95% CI, 1.06-1.13]) and all-cause mortality CAC: hazard ratio, 1.04 [95% CI, 1.01-1.08]; AAC: hazard ratio, 1.05 [95% CI, 1.01-1.08]). The incremental value of CAC (0.17 [95% CI, 0.08-0.23]) and AAC (0.15 [95% CI, 0.07-0.29]) to the pool cohort equation by net reclassification index was comparable. Notably, 45% of participants with 0 CAC showed some degree of AAC. Each 2-fold increase in AAC was associated with an increased risk of cardiovascular events (hazard ratio, 1.07 [95% CI, 1.01-1.19]) but not all-cause mortality among participants with 0 CAC.

Conclusions: AAC is comparable to CAC in predicting cardiovascular events and all-cause mortality among Black adults, potentially valuable when CAC is absent.

查看原文本刊更多论文

黑人成年人腹部钙化与冠状动脉钙化及心血管事件和死亡率的比较

背景：尽管黑人成年人的冠状动脉钙化（CAC）评分与其他群体相当或较低，但他们的心血管风险却比其他群体高，这表明CAC可能低估了心血管风险。在 CAC 之前的腹主动脉钙化（AAC）可能能更好地预测黑人成年人的心血管事件，因为他们容易发生早期动脉粥样硬化性心血管疾病，并在 CAC 分数较低时发生过多的心血管事件：我们纳入了 2551 名参加 JHS（杰克逊心脏研究）第 2 次检查（2005-2008 年）且未患心血管疾病的参与者，并一直跟踪到 2016 年。Cox回归估算了心血管事件发生的危险比，心血管事件定义为心肌梗死、中风、心力衰竭和全因死亡率的综合。评估了CAC和AAC加入美国心脏病学会/美国心脏协会心血管风险算法（集合队列方程）后的预测价值：平均年龄为 57±10 岁，66% 为女性。在12.6年的随访期间，共观察到287例（11.3%）心血管事件和360例（14.1%）死亡病例。对人口统计学和临床变量进行调整后，CAC 和 AAC 每增加 2 倍都与心血管事件（CAC：危险比，1.10 [95% CI，1.06-1.13]；AAC：危险比，1.10 [95% CI，1.06-1.13]）和全因死亡率（CAC：危险比，1.04 [95% CI，1.01-1.08]；AAC：危险比，1.05 [95% CI，1.01-1.08]）相关。按净再分类指数计算，CAC（0.17 [95% CI, 0.08-0.23]）和 AAC（0.15 [95% CI, 0.07-0.29]）与集合队列方程的增量值相当。值得注意的是，在 CAC 为 0 的参与者中，有 45% 显示出一定程度的 AAC。在CAC为0的参与者中，AAC每增加2倍与心血管事件风险增加有关（危险比为1.07 [95% CI, 1.01-1.19]），但与全因死亡率无关：在预测黑人成年人的心血管事件和全因死亡率方面，AAC 与 CAC 不相上下，在没有 CAC 的情况下具有潜在价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Circulation: Cardiovascular Imaging 医学-核医学

CiteScore

6.30

自引率

2.70%

发文量

225

审稿时长

6-12 weeks

期刊介绍： Circulation: Cardiovascular Imaging, an American Heart Association journal, publishes high-quality, patient-centric articles focusing on observational studies, clinical trials, and advances in applied (translational) research. The journal features innovative, multimodality approaches to the diagnosis and risk stratification of cardiovascular disease. Modalities covered include echocardiography, cardiac computed tomography, cardiac magnetic resonance imaging and spectroscopy, magnetic resonance angiography, cardiac positron emission tomography, noninvasive assessment of vascular and endothelial function, radionuclide imaging, molecular imaging, and others. Article types considered by Circulation: Cardiovascular Imaging include Original Research, Research Letters, Advances in Cardiovascular Imaging, Clinical Implications of Molecular Imaging Research, How to Use Imaging, Translating Novel Imaging Technologies into Clinical Applications, and Cardiovascular Images.