|Cardiovascular imaging for assessing cardiovascular risk in asymptomatic men versus women: the multi-ethnic study of atherosclerosis (MESA).|
|PMID: 21068189 Owner: NLM Status: MEDLINE|
|BACKGROUND: Coronary artery calcium (CAC), carotid intima-media thickness, and left ventricular (LV) mass and geometry offer the potential to characterize incident cardiovascular disease (CVD) risk in clinically asymptomatic individuals. The objective of the study was to compare these cardiovascular imaging measures for their overall and sex-specific ability to predict CVD.
METHODS AND RESULTS: The study sample consisted of 4965 Multi-Ethnic Study of Atherosclerosis participants (48% men; mean age, 62±10 years). They were free of CVD at baseline and were followed for a median of 5.8 years. There were 297 CVD events, including 187 coronary heart disease (CHD) events, 65 strokes, and 91 heart failure (HF) events. CAC was most strongly associated with CHD (hazard ratio [HR], 2.3 per 1 SD; 95% CI, 1.9 to 2.8) and all CVD events (HR, 1.7; 95% CI, 1.5 to 1.9). Most strongly associated with stroke were LV mass (HR, 1.3; 95% CI, 1.1 to 1.7) and LV mass/volume ratio (HR, 1.3; 95% CI, 1.1 to 1.6). LV mass showed the strongest association with HF (HR, 1.8; 95% CI, 1.6 to 2.1). There were no significant interactions for imaging measures with sex and ethnicity for any CVD outcome. Compared with traditional risk factors alone, overall risk prediction (C statistic) for future CHD, HF, and all CVD was significantly improved by adding CAC, LV mass, and CAC, respectively (all P<0.05).
CONCLUSIONS: There was no evidence that imaging measures differed in association with incident CVD by sex. CAC was most strongly associated with CHD and CVD; LV mass and LV concentric remodeling best predicted stroke; and LV mass best predicted HF.
|Aditya Jain; Robyn L McClelland; Joseph F Polak; Steven Shea; Gregory L Burke; Diane E Bild; Karol E Watson; Matthew J Budoff; Kiang Liu; Wendy S Post; Aaron R Folsom; João A C Lima; David A Bluemke|
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|Type: Journal Article; Research Support, N.I.H., Extramural Date: 2010-11-10|
|Title: Circulation. Cardiovascular imaging Volume: 4 ISSN: 1942-0080 ISO Abbreviation: Circ Cardiovasc Imaging Publication Date: 2011 Jan|
|Created Date: 2011-01-19 Completed Date: 2011-02-23 Revised Date: 2013-05-27|
Medline Journal Info:
|Nlm Unique ID: 101479935 Medline TA: Circ Cardiovasc Imaging Country: United States|
|Languages: eng Pagination: 8-15 Citation Subset: IM|
|Department of Radiology, Johns Hopkins University, Baltimore, MD, USA.|
|APA/MLA Format Download EndNote Download BibTex|
Aged, 80 and over
Arteriosclerosis / ethnology, radiography
Calcinosis / ethnology, radiography*
Cardiovascular Diseases / diagnosis*, ethnology*
Carotid Arteries / ultrasonography*
Coronary Artery Disease / ethnology, radiography
Heart Ventricles / pathology*
Magnetic Resonance Imaging / methods
Predictive Value of Tests
Sensitivity and Specificity
Tomography, X-Ray Computed / methods
Tunica Intima / ultrasonography
Tunica Media / ultrasonography
|N01-HC-95159/HC/NHLBI NIH HHS; N01-HC-95160/HC/NHLBI NIH HHS; N01-HC-95161/HC/NHLBI NIH HHS; N01-HC-95162/HC/NHLBI NIH HHS; N01-HC-95163/HC/NHLBI NIH HHS; N01-HC-95164/HC/NHLBI NIH HHS; N01-HC-95165/HC/NHLBI NIH HHS; N01-HC-95166/HC/NHLBI NIH HHS; N01-HC-95167/HC/NHLBI NIH HHS; N01-HC-95168/HC/NHLBI NIH HHS; N01-HC-95169/HC/NHLBI NIH HHS; Z99 CL999999/CL/CLC NIH HHS; ZIA CL090019-01/CL/CLC NIH HHS; ZIA EB000072-01/EB/NIBIB NIH HHS|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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