Document Detail


Cardiovascular imaging for assessing cardiovascular risk in asymptomatic men versus women: the multi-ethnic study of atherosclerosis (MESA).
MedLine Citation:
PMID:  21068189     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2010-11-10
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  4     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2011 Jan 
Date Detail:
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    
Other Details:
Languages:  eng     Pagination:  8-15     Citation Subset:  IM    
Affiliation:
Department of Radiology, Johns Hopkins University, Baltimore, MD, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Arteriosclerosis / ethnology,  radiography
Calcinosis / ethnology,  radiography*
Cardiovascular Diseases / diagnosis*,  ethnology*
Carotid Arteries / ultrasonography*
Causality
Cohort Studies
Comorbidity
Coronary Artery Disease / ethnology,  radiography
Ethnic Groups
Female
Follow-Up Studies
Heart Ventricles / pathology*
Humans
Longitudinal Studies
Magnetic Resonance Imaging / methods
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Risk Factors
Sensitivity and Specificity
Sex Distribution
Tomography, X-Ray Computed / methods
Tunica Intima / ultrasonography
Tunica Media / ultrasonography
Grant Support
ID/Acronym/Agency:
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
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