Incidence and Progression of Aortic Valve Calcium in the Multi-Ethnic Study of Atherosclerosis (MESA) - 05/08/11
Résumé |
Aortic valve calcium (AVC) is common among older adults and shares epidemiologic and histopathologic similarities to atherosclerosis. However, prospective studies have failed to identify meaningful risk associations with incident (“new”) AVC or its progression. In the present study, AVC was quantified from serial computed tomographic images from 5,880 participants (aged 45 to 84 years) in the Multi-Ethnic Study of Atherosclerosis, using the Agatston method. Multivariate backward selection modeling was used to identify the risk factors for incident AVC and AVC progression. During a mean follow-up of 2.4 ± 0.9 years, 210 subjects (4.1%) developed incident AVC. The incidence rate (mean 1.7%/year) increased significantly with age (p <0.001). The risk factors for incident AVC included age, male gender, body mass index, current smoking, and the use of lipid-lowering and antihypertensive medications. Among those with AVC at baseline, the median rate of AVC progression was 2 Agatston units/year (interquartile range −21 to 37). The baseline Agatston score was a strong, independent predictor of progression, especially among those with high calcium scores at baseline. In conclusion, in this ethnically diverse, preclinical cohort, the rate of incident AVC increased significantly with age. The incident AVC risk was associated with several traditional cardiovascular risk factors, specifically age, male gender, body mass index, current smoking, and the use of both antihypertensive and lipid-lowering medications. AVC progression risk was associated with male gender and the baseline Agatston score. Additional research is needed to determine whether age- and stage-specific mechanisms underlie the risk of AVC progression.
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This research was supported by grant R01-HL-63963-01A1, and by contracts N01-HC-95159 through N01-HC-95165 and N01-HC-95169 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland. |
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Dr. Budoff has received honoraria from, and is on, the Speakers' Bureau of GE Healthcare (Bethesda, Maryland). Dr. O'Brien has received honoraria from, and is on, the Speakers' Bureaus of AstraZeneca (Wilmington, Delaware), Bristol-Myers Squibb (New York, New York), and Merck and Co., Inc. (Whitehouse Station, New Jersey). |
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Drs. Owens, Katz and O'Brien had full access to the data and take responsibility for its integrity. All authors have read and approve the manuscript as submitted. |
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The National Heart, Lung, and Blood Institute participated in the design and conduct of the MESA study, and the National Heart, Lung, and Blood Institute Project Office reviewed and approved the manuscript before submission. |
Vol 105 - N° 5
P. 701-708 - mars 2010 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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