Interplay Between Social Vulnerability Index and Coronary Artery Calcium Scores With Major Adverse Cardiovascular Events.

IF 6.5 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Circulation: Cardiovascular Imaging Pub Date : 2025-03-01 Epub Date: 2025-02-18 DOI:10.1161/CIRCIMAGING.124.016658

Zainab Albar, Pedro R V O Salerno, Nour Tashtish, Santosh K Sirasapalli, Shuo Li, Khurram Nasir, Salil Deo, Sanjay Rajagopalan, Sadeer Al-Kindi

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引用次数: 0

Abstract

Background: Coronary artery calcium (CAC) scoring predicts cardiovascular risk, but social determinants of health may play a role in its prognostic ability. We examined whether the Social Vulnerability Index (SVI) modifies the association between CAC and major adverse cardiovascular events (MACE) in a community-based screening cohort.

Methods: We studied 49 224 participants without known cardiovascular disease referred for CAC scanning from 2014 to 2022 based on cardiovascular risk factors. SVI was determined for each participant based on the census tract. We examined 8-year incidence of MACE (myocardial infarction, stroke, heart failure, revascularization, death) by SVI quartile across CAC score strata (0, 1-99, 100-399, ≥400). Cox proportional hazard models estimated hazard ratios for MACE, associated with demographics, metabolic factors, and CAC.

Results: Higher SVI was associated with female sex, non-White race, greater comorbidities, and higher CAC scores. The 8-year MACE rate increased monotonically by SVI quartile, with a hazard ratio of 1.54 (95% CI, 1.24-1.90, P<0.001) for the highest versus lowest SVI quartile after adjustment. The association between CAC score and MACE was modified by SVI, with a stronger gradient in risk across CAC strata apparent among vulnerable subgroups.

Conclusions: In this no-cost community-based CAC cohort, SVI independently predicted adverse cardiovascular outcomes across all CAC strata. Focused efforts to mitigate the incremental risk associated with social vulnerability are needed.

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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.