Assessment by Cardiovascular Magnetic Resonance, Electron Beam Computed Tomography, and Carotid Ultrasonography of the Distribution of Subclinical Atherosclerosis Across Framingham Risk Strata
Screening for subclinical atherosclerosis has been advocated for individuals at intermediate global risk for coronary heart disease (CHD). However, the distribution of subclinical atherosclerosis test values across CHD risk strata is unknown. We studied a stratified random sample of 292 participants...
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| Veröffentlicht in: | The American journal of cardiology 2007-02, Vol.99 (3), p.310-314 |
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| creator | Kathiresan, Sekar, MD Larson, Martin G., ScD Keyes, Michelle J., MA Polak, Joseph F., MD Wolf, Philip A., MD D’Agostino, Ralph B., PhD Jaffer, Farouc A., MD, PhD Clouse, Melvin E., MD Levy, Daniel, MD Manning, Warren J., MD O’Donnell, Christopher J., MD, MPH |
| description | Screening for subclinical atherosclerosis has been advocated for individuals at intermediate global risk for coronary heart disease (CHD). However, the distribution of subclinical atherosclerosis test values across CHD risk strata is unknown. We studied a stratified random sample of 292 participants (mean age 59.5 years, 50% women) from the offspring cohort of the Framingham Heart Study who were free of clinically apparent cardiovascular disease. We assessed abdominal and thoracic aortic plaque burden by cardiovascular magnetic resonance (CMR), coronary artery calcification (CAC) and thoracic aortic calcification (TAC) by electron beam computed tomography, and common carotid intima-media thickness (C-IMT) by ultrasonography. We categorized the upper 20% of each measurement as a high level of atherosclerosis and evaluated these variables across clinically relevant Framingham CHD risk score strata (low, intermediate, and high risk). In age-adjusted analyses in men and women, correlations across CMR aortic plaque, CAC, TAC, and C-IMT were low (maximum r = 0.30 for CAC:TAC in women, p |
| doi_str_mv | 10.1016/j.amjcard.2006.08.028 |
| format | Article |
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However, the distribution of subclinical atherosclerosis test values across CHD risk strata is unknown. We studied a stratified random sample of 292 participants (mean age 59.5 years, 50% women) from the offspring cohort of the Framingham Heart Study who were free of clinically apparent cardiovascular disease. We assessed abdominal and thoracic aortic plaque burden by cardiovascular magnetic resonance (CMR), coronary artery calcification (CAC) and thoracic aortic calcification (TAC) by electron beam computed tomography, and common carotid intima-media thickness (C-IMT) by ultrasonography. We categorized the upper 20% of each measurement as a high level of atherosclerosis and evaluated these variables across clinically relevant Framingham CHD risk score strata (low, intermediate, and high risk). In age-adjusted analyses in men and women, correlations across CMR aortic plaque, CAC, TAC, and C-IMT were low (maximum r = 0.30 for CAC:TAC in women, p <0.005). In men and women, the proportion of subjects with high atherosclerosis test results for any of these measurements increased significantly across Framingham CHD risk score strata (Kruskal-Wallis test, p <0.0001). In the intermediate Framingham CHD risk score category, 14% of men and 25% of women had a high atherosclerosis result on ≥2 measurements. However, different participants were identified as having high atherosclerosis by each modality. For example, in a comparison of the overlap across CMR aortic plaque, CAC, and C-IMT, only 4% of men and 16% of women were classified as having high atherosclerosis on all 3 measurements. In conclusion, in a community-based sample, correlations among subclinical atherosclerosis test results are low, and a substantial proportion has high levels of subclinical atherosclerosis detected on ≥2 imaging tests.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2006.08.028</identifier><identifier>PMID: 17261388</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Aorta, Abdominal - diagnostic imaging ; Aorta, Abdominal - pathology ; Aorta, Thoracic - diagnostic imaging ; Aorta, Thoracic - pathology ; Atherosclerosis (general aspects, experimental research) ; Atherosclerosis - diagnosis ; Atherosclerosis - epidemiology ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; Carotid Artery, Common - diagnostic imaging ; Child ; Child, Preschool ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Incidence ; Magnetic Resonance Imaging - methods ; Male ; Medical sciences ; Middle Aged ; Retrospective Studies ; Risk Assessment - methods ; Risk Factors ; Sex Distribution ; Tomography ; Tomography, X-Ray Computed - methods ; Ultrasonic imaging ; Ultrasonography ; United States - epidemiology</subject><ispartof>The American journal of cardiology, 2007-02, Vol.99 (3), p.310-314</ispartof><rights>Elsevier Inc.</rights><rights>2007 Elsevier Inc.</rights><rights>2007 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. Feb 1, 2007</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c572t-ae1a6fc41dd3cb9f2163c94aa6722a64f8491fc0f64f188ae6608b398f3db1c63</citedby><cites>FETCH-LOGICAL-c572t-ae1a6fc41dd3cb9f2163c94aa6722a64f8491fc0f64f188ae6608b398f3db1c63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.amjcard.2006.08.028$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18912321$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17261388$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kathiresan, Sekar, MD</creatorcontrib><creatorcontrib>Larson, Martin G., ScD</creatorcontrib><creatorcontrib>Keyes, Michelle J., MA</creatorcontrib><creatorcontrib>Polak, Joseph F., MD</creatorcontrib><creatorcontrib>Wolf, Philip A., MD</creatorcontrib><creatorcontrib>D’Agostino, Ralph B., PhD</creatorcontrib><creatorcontrib>Jaffer, Farouc A., MD, PhD</creatorcontrib><creatorcontrib>Clouse, Melvin E., MD</creatorcontrib><creatorcontrib>Levy, Daniel, MD</creatorcontrib><creatorcontrib>Manning, Warren J., MD</creatorcontrib><creatorcontrib>O’Donnell, Christopher J., MD, MPH</creatorcontrib><title>Assessment by Cardiovascular Magnetic Resonance, Electron Beam Computed Tomography, and Carotid Ultrasonography of the Distribution of Subclinical Atherosclerosis Across Framingham Risk Strata</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Screening for subclinical atherosclerosis has been advocated for individuals at intermediate global risk for coronary heart disease (CHD). However, the distribution of subclinical atherosclerosis test values across CHD risk strata is unknown. We studied a stratified random sample of 292 participants (mean age 59.5 years, 50% women) from the offspring cohort of the Framingham Heart Study who were free of clinically apparent cardiovascular disease. We assessed abdominal and thoracic aortic plaque burden by cardiovascular magnetic resonance (CMR), coronary artery calcification (CAC) and thoracic aortic calcification (TAC) by electron beam computed tomography, and common carotid intima-media thickness (C-IMT) by ultrasonography. We categorized the upper 20% of each measurement as a high level of atherosclerosis and evaluated these variables across clinically relevant Framingham CHD risk score strata (low, intermediate, and high risk). In age-adjusted analyses in men and women, correlations across CMR aortic plaque, CAC, TAC, and C-IMT were low (maximum r = 0.30 for CAC:TAC in women, p <0.005). In men and women, the proportion of subjects with high atherosclerosis test results for any of these measurements increased significantly across Framingham CHD risk score strata (Kruskal-Wallis test, p <0.0001). In the intermediate Framingham CHD risk score category, 14% of men and 25% of women had a high atherosclerosis result on ≥2 measurements. However, different participants were identified as having high atherosclerosis by each modality. For example, in a comparison of the overlap across CMR aortic plaque, CAC, and C-IMT, only 4% of men and 16% of women were classified as having high atherosclerosis on all 3 measurements. In conclusion, in a community-based sample, correlations among subclinical atherosclerosis test results are low, and a substantial proportion has high levels of subclinical atherosclerosis detected on ≥2 imaging tests.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Distribution</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aorta, Abdominal - diagnostic imaging</subject><subject>Aorta, Abdominal - pathology</subject><subject>Aorta, Thoracic - diagnostic imaging</subject><subject>Aorta, Thoracic - pathology</subject><subject>Atherosclerosis (general aspects, experimental research)</subject><subject>Atherosclerosis - diagnosis</subject><subject>Atherosclerosis - epidemiology</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology</subject><subject>Cardiology. 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Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Carotid Artery, Common - diagnostic imaging</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Diagnosis, Differential</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Incidence</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Risk Assessment - methods</topic><topic>Risk Factors</topic><topic>Sex Distribution</topic><topic>Tomography</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kathiresan, Sekar, MD</creatorcontrib><creatorcontrib>Larson, Martin G., ScD</creatorcontrib><creatorcontrib>Keyes, Michelle J., MA</creatorcontrib><creatorcontrib>Polak, Joseph F., MD</creatorcontrib><creatorcontrib>Wolf, Philip A., MD</creatorcontrib><creatorcontrib>D’Agostino, Ralph B., PhD</creatorcontrib><creatorcontrib>Jaffer, Farouc A., MD, PhD</creatorcontrib><creatorcontrib>Clouse, Melvin E., MD</creatorcontrib><creatorcontrib>Levy, Daniel, MD</creatorcontrib><creatorcontrib>Manning, Warren J., MD</creatorcontrib><creatorcontrib>O’Donnell, Christopher J., MD, MPH</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Biotechnology Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kathiresan, Sekar, MD</au><au>Larson, Martin G., ScD</au><au>Keyes, Michelle J., MA</au><au>Polak, Joseph F., MD</au><au>Wolf, Philip A., MD</au><au>D’Agostino, Ralph B., PhD</au><au>Jaffer, Farouc A., MD, PhD</au><au>Clouse, Melvin E., MD</au><au>Levy, Daniel, MD</au><au>Manning, Warren J., MD</au><au>O’Donnell, Christopher J., MD, MPH</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment by Cardiovascular Magnetic Resonance, Electron Beam Computed Tomography, and Carotid Ultrasonography of the Distribution of Subclinical Atherosclerosis Across Framingham Risk Strata</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2007-02-01</date><risdate>2007</risdate><volume>99</volume><issue>3</issue><spage>310</spage><epage>314</epage><pages>310-314</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Screening for subclinical atherosclerosis has been advocated for individuals at intermediate global risk for coronary heart disease (CHD). However, the distribution of subclinical atherosclerosis test values across CHD risk strata is unknown. We studied a stratified random sample of 292 participants (mean age 59.5 years, 50% women) from the offspring cohort of the Framingham Heart Study who were free of clinically apparent cardiovascular disease. We assessed abdominal and thoracic aortic plaque burden by cardiovascular magnetic resonance (CMR), coronary artery calcification (CAC) and thoracic aortic calcification (TAC) by electron beam computed tomography, and common carotid intima-media thickness (C-IMT) by ultrasonography. We categorized the upper 20% of each measurement as a high level of atherosclerosis and evaluated these variables across clinically relevant Framingham CHD risk score strata (low, intermediate, and high risk). In age-adjusted analyses in men and women, correlations across CMR aortic plaque, CAC, TAC, and C-IMT were low (maximum r = 0.30 for CAC:TAC in women, p <0.005). In men and women, the proportion of subjects with high atherosclerosis test results for any of these measurements increased significantly across Framingham CHD risk score strata (Kruskal-Wallis test, p <0.0001). In the intermediate Framingham CHD risk score category, 14% of men and 25% of women had a high atherosclerosis result on ≥2 measurements. However, different participants were identified as having high atherosclerosis by each modality. For example, in a comparison of the overlap across CMR aortic plaque, CAC, and C-IMT, only 4% of men and 16% of women were classified as having high atherosclerosis on all 3 measurements. In conclusion, in a community-based sample, correlations among subclinical atherosclerosis test results are low, and a substantial proportion has high levels of subclinical atherosclerosis detected on ≥2 imaging tests.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>17261388</pmid><doi>10.1016/j.amjcard.2006.08.028</doi><tpages>5</tpages></addata></record> |
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| ispartof | The American journal of cardiology, 2007-02, Vol.99 (3), p.310-314 |
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| subjects | Adolescent Adult Age Distribution Aged Aged, 80 and over Aorta, Abdominal - diagnostic imaging Aorta, Abdominal - pathology Aorta, Thoracic - diagnostic imaging Aorta, Thoracic - pathology Atherosclerosis (general aspects, experimental research) Atherosclerosis - diagnosis Atherosclerosis - epidemiology Biological and medical sciences Blood and lymphatic vessels Cardiology Cardiology. Vascular system Cardiovascular Cardiovascular disease Carotid Artery, Common - diagnostic imaging Child Child, Preschool Diagnosis, Differential Female Follow-Up Studies Humans Incidence Magnetic Resonance Imaging - methods Male Medical sciences Middle Aged Retrospective Studies Risk Assessment - methods Risk Factors Sex Distribution Tomography Tomography, X-Ray Computed - methods Ultrasonic imaging Ultrasonography United States - epidemiology |
| title | Assessment by Cardiovascular Magnetic Resonance, Electron Beam Computed Tomography, and Carotid Ultrasonography of the Distribution of Subclinical Atherosclerosis Across Framingham Risk Strata |
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