Cardiovascular events with absent or minimal coronary calcification: The Multi-Ethnic Study of Atherosclerosis (MESA)
Background Elevated coronary artery calcium (CAC) is a marker for increase risk of coronary heart disease (CHD). Although most CHD events occur among individuals with advanced CAC, CHD can also occur in individuals with little or no calcified plaque. In this study, we sought to evaluate the characte...
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| Veröffentlicht in: | The American heart journal 2009-10, Vol.158 (4), p.554-561 |
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| creator | Budoff, Matthew J., MD, FACC, FAHA McClelland, Robyn L., PhD Nasir, Khurram, MD, MPH Greenland, Philip, MD Kronmal, Richard A., PhD Kondos, George T., MD Shea, Steven, MD Lima, Joao A.C., MD Blumenthal, Roger S., MD |
| description | Background Elevated coronary artery calcium (CAC) is a marker for increase risk of coronary heart disease (CHD). Although most CHD events occur among individuals with advanced CAC, CHD can also occur in individuals with little or no calcified plaque. In this study, we sought to evaluate the characteristics associated with incident CHD events in the setting of minimal (score ≤10) or absent CAC (score of zero). Methods Asymptomatic participants in the MESA (N = 6,809) were followed for occurrence of all CHD events (including myocardial infarction, angina, resuscitated cardiac arrest, or CHD death) and hard CHD events (myocardial infarction or CHD death). Time to incident CHD was modeled using age-and gender-adjusted Cox regression. Results The final study population consisted of 3,923 MESA asymptomatic participants (mean age 58 ± 9 years, 39% males) who had CAC scores of 0 to 10. Overall, no detectable CAC was seen in 3415 individuals, whereas 508 had CAC scores of 1 to 10. During follow-up (median 4.1 years), there were 16 incident hard events and 28 all CHD events in individuals with absent or minimal CAC. In age-, gender-, race-, and CHD risk factor-adjusted analysis, minimal CAC (1-10) was associated with an estimated 3-fold greater risk of a hard CHD event (HR 3.23, 95% CI 1.17-8.95) or of all CHD event (HR 3.66, 95% CI 1.71-7.85) compared to those with CAC = 0. Former smoking (HR 3.57, 95% CI 1.08-11.77), current smoking (HR 4.93, 95% CI 1.20-20.30), and diabetes (HR 3.09, 95% CI 1.07-8.93) were significant risk factors for events in those with CAC = 0. Conclusion Asymptomatic persons with absent or minimal CAC are at very low risk of future cardiovascular events. Individuals with minimal CAC (1-10) were significantly increased to 3-fold increased risk for incident CHD events relative to those with CAC scores of zero. |
| doi_str_mv | 10.1016/j.ahj.2009.08.007 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2766514</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002870309006188</els_id><sourcerecordid>67670350</sourcerecordid><originalsourceid>FETCH-LOGICAL-c593t-ada1667244616e3189187794f30825fe5544a5afb0306fe44ddbae9498e0c3a23</originalsourceid><addsrcrecordid>eNqFkk2P0zAQhi0EYpfCD-CCLCEQHFLGjmM7IK1UVeVD2hWHLmfLdRzi4saLnRT13-Oo1S7sAS62Rn5mPO-8g9BzAnMChL_bznW3nVOAeg5yDiAeoHMCtSi4YOwhOgcAWkgB5Rl6ktI2h5xK_hidkVpIwgg7R-NSx8aFvU5m9Dpiu7f9kPAvN3RYb1IOcIh453q30x6bEEOv4wEb7Y1rndGDC_17fN1ZfDX6wRWroeudwethbA44tHgxdDaGZPx0uoTfXK3Wi7dP0aNW-2Sfne4Z-vZxdb38XFx-_fRlubgsTFWXQ6EbTTgXlDFOuC2JrIkUomZtCZJWra0qxnSl2w2UwFvLWNNstK1ZLS2YUtNyhi6OdW_Gzc42JsuJ2qubmNXEgwraqb9fetep72GvqOC8IiwXeH0qEMPP0aZB7Vwy1nvd2zAmxQXP463gvyAlRFKRVc3Qy3vgNoyxz1NQpIIslOaamSJHyuSxpWjb254JqMl7tVXZezV5r0Cq7H3OefGn2LuMk9kZeHUCstvat1H3xqVbjlIgjNcT9-HI2WzN3tmoknG2N7Zx0ZpBNcH9s42Le9nG5_XJH_6wB5vu1KpEFaj1tKTTjkKd15NIWf4GQB_haw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1504612676</pqid></control><display><type>article</type><title>Cardiovascular events with absent or minimal coronary calcification: The Multi-Ethnic Study of Atherosclerosis (MESA)</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><source>ProQuest Central UK/Ireland</source><creator>Budoff, Matthew J., MD, FACC, FAHA ; McClelland, Robyn L., PhD ; Nasir, Khurram, MD, MPH ; Greenland, Philip, MD ; Kronmal, Richard A., PhD ; Kondos, George T., MD ; Shea, Steven, MD ; Lima, Joao A.C., MD ; Blumenthal, Roger S., MD</creator><creatorcontrib>Budoff, Matthew J., MD, FACC, FAHA ; McClelland, Robyn L., PhD ; Nasir, Khurram, MD, MPH ; Greenland, Philip, MD ; Kronmal, Richard A., PhD ; Kondos, George T., MD ; Shea, Steven, MD ; Lima, Joao A.C., MD ; Blumenthal, Roger S., MD</creatorcontrib><description>Background Elevated coronary artery calcium (CAC) is a marker for increase risk of coronary heart disease (CHD). Although most CHD events occur among individuals with advanced CAC, CHD can also occur in individuals with little or no calcified plaque. In this study, we sought to evaluate the characteristics associated with incident CHD events in the setting of minimal (score ≤10) or absent CAC (score of zero). Methods Asymptomatic participants in the MESA (N = 6,809) were followed for occurrence of all CHD events (including myocardial infarction, angina, resuscitated cardiac arrest, or CHD death) and hard CHD events (myocardial infarction or CHD death). Time to incident CHD was modeled using age-and gender-adjusted Cox regression. Results The final study population consisted of 3,923 MESA asymptomatic participants (mean age 58 ± 9 years, 39% males) who had CAC scores of 0 to 10. Overall, no detectable CAC was seen in 3415 individuals, whereas 508 had CAC scores of 1 to 10. During follow-up (median 4.1 years), there were 16 incident hard events and 28 all CHD events in individuals with absent or minimal CAC. In age-, gender-, race-, and CHD risk factor-adjusted analysis, minimal CAC (1-10) was associated with an estimated 3-fold greater risk of a hard CHD event (HR 3.23, 95% CI 1.17-8.95) or of all CHD event (HR 3.66, 95% CI 1.71-7.85) compared to those with CAC = 0. Former smoking (HR 3.57, 95% CI 1.08-11.77), current smoking (HR 4.93, 95% CI 1.20-20.30), and diabetes (HR 3.09, 95% CI 1.07-8.93) were significant risk factors for events in those with CAC = 0. Conclusion Asymptomatic persons with absent or minimal CAC are at very low risk of future cardiovascular events. Individuals with minimal CAC (1-10) were significantly increased to 3-fold increased risk for incident CHD events relative to those with CAC scores of zero.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2009.08.007</identifier><identifier>PMID: 19781414</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Age Distribution ; Aged ; Aged, 80 and over ; Atherosclerosis (general aspects, experimental research) ; Atherosclerosis - blood ; Atherosclerosis - diagnosis ; Atherosclerosis - ethnology ; Biological and medical sciences ; Blood and lymphatic vessels ; Calcinosis - blood ; Calcinosis - diagnosis ; Calcinosis - ethnology ; Calcium - blood ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; Carotid Arteries - diagnostic imaging ; Cholesterol ; Coronary Artery Disease - blood ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - ethnology ; Coronary heart disease ; Ethnic Groups ; Female ; Follow-Up Studies ; Heart ; Heart attacks ; Humans ; Incidence ; Low density lipoprotein ; Male ; Medical sciences ; Middle Aged ; Older people ; Prognosis ; Prospective Studies ; Risk Factors ; Severity of Illness Index ; Sex Distribution ; Time Factors ; Tomography, X-Ray Computed ; Ultrasonography ; United States - epidemiology</subject><ispartof>The American heart journal, 2009-10, Vol.158 (4), p.554-561</ispartof><rights>Mosby, Inc.</rights><rights>2009 Mosby, Inc.</rights><rights>2009 INIST-CNRS</rights><rights>Copyright Elsevier Limited Oct 2009</rights><rights>2009 Mosby, Inc. All rights reserved. 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c593t-ada1667244616e3189187794f30825fe5544a5afb0306fe44ddbae9498e0c3a23</citedby><cites>FETCH-LOGICAL-c593t-ada1667244616e3189187794f30825fe5544a5afb0306fe44ddbae9498e0c3a23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1504612676?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,314,780,784,885,3548,27923,27924,45994,64384,64386,64388,72240</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22014694$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19781414$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Budoff, Matthew J., MD, FACC, FAHA</creatorcontrib><creatorcontrib>McClelland, Robyn L., PhD</creatorcontrib><creatorcontrib>Nasir, Khurram, MD, MPH</creatorcontrib><creatorcontrib>Greenland, Philip, MD</creatorcontrib><creatorcontrib>Kronmal, Richard A., PhD</creatorcontrib><creatorcontrib>Kondos, George T., MD</creatorcontrib><creatorcontrib>Shea, Steven, MD</creatorcontrib><creatorcontrib>Lima, Joao A.C., MD</creatorcontrib><creatorcontrib>Blumenthal, Roger S., MD</creatorcontrib><title>Cardiovascular events with absent or minimal coronary calcification: The Multi-Ethnic Study of Atherosclerosis (MESA)</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Background Elevated coronary artery calcium (CAC) is a marker for increase risk of coronary heart disease (CHD). Although most CHD events occur among individuals with advanced CAC, CHD can also occur in individuals with little or no calcified plaque. In this study, we sought to evaluate the characteristics associated with incident CHD events in the setting of minimal (score ≤10) or absent CAC (score of zero). Methods Asymptomatic participants in the MESA (N = 6,809) were followed for occurrence of all CHD events (including myocardial infarction, angina, resuscitated cardiac arrest, or CHD death) and hard CHD events (myocardial infarction or CHD death). Time to incident CHD was modeled using age-and gender-adjusted Cox regression. Results The final study population consisted of 3,923 MESA asymptomatic participants (mean age 58 ± 9 years, 39% males) who had CAC scores of 0 to 10. Overall, no detectable CAC was seen in 3415 individuals, whereas 508 had CAC scores of 1 to 10. During follow-up (median 4.1 years), there were 16 incident hard events and 28 all CHD events in individuals with absent or minimal CAC. In age-, gender-, race-, and CHD risk factor-adjusted analysis, minimal CAC (1-10) was associated with an estimated 3-fold greater risk of a hard CHD event (HR 3.23, 95% CI 1.17-8.95) or of all CHD event (HR 3.66, 95% CI 1.71-7.85) compared to those with CAC = 0. Former smoking (HR 3.57, 95% CI 1.08-11.77), current smoking (HR 4.93, 95% CI 1.20-20.30), and diabetes (HR 3.09, 95% CI 1.07-8.93) were significant risk factors for events in those with CAC = 0. Conclusion Asymptomatic persons with absent or minimal CAC are at very low risk of future cardiovascular events. Individuals with minimal CAC (1-10) were significantly increased to 3-fold increased risk for incident CHD events relative to those with CAC scores of zero.</description><subject>Age Distribution</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Atherosclerosis (general aspects, experimental research)</subject><subject>Atherosclerosis - blood</subject><subject>Atherosclerosis - diagnosis</subject><subject>Atherosclerosis - ethnology</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Calcinosis - blood</subject><subject>Calcinosis - diagnosis</subject><subject>Calcinosis - ethnology</subject><subject>Calcium - blood</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Carotid Arteries - diagnostic imaging</subject><subject>Cholesterol</subject><subject>Coronary Artery Disease - blood</subject><subject>Coronary Artery Disease - diagnosis</subject><subject>Coronary Artery Disease - ethnology</subject><subject>Coronary heart disease</subject><subject>Ethnic Groups</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Incidence</subject><subject>Low density lipoprotein</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Older people</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Sex Distribution</subject><subject>Time Factors</subject><subject>Tomography, X-Ray Computed</subject><subject>Ultrasonography</subject><subject>United States - epidemiology</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkk2P0zAQhi0EYpfCD-CCLCEQHFLGjmM7IK1UVeVD2hWHLmfLdRzi4saLnRT13-Oo1S7sAS62Rn5mPO-8g9BzAnMChL_bznW3nVOAeg5yDiAeoHMCtSi4YOwhOgcAWkgB5Rl6ktI2h5xK_hidkVpIwgg7R-NSx8aFvU5m9Dpiu7f9kPAvN3RYb1IOcIh453q30x6bEEOv4wEb7Y1rndGDC_17fN1ZfDX6wRWroeudwethbA44tHgxdDaGZPx0uoTfXK3Wi7dP0aNW-2Sfne4Z-vZxdb38XFx-_fRlubgsTFWXQ6EbTTgXlDFOuC2JrIkUomZtCZJWra0qxnSl2w2UwFvLWNNstK1ZLS2YUtNyhi6OdW_Gzc42JsuJ2qubmNXEgwraqb9fetep72GvqOC8IiwXeH0qEMPP0aZB7Vwy1nvd2zAmxQXP463gvyAlRFKRVc3Qy3vgNoyxz1NQpIIslOaamSJHyuSxpWjb254JqMl7tVXZezV5r0Cq7H3OefGn2LuMk9kZeHUCstvat1H3xqVbjlIgjNcT9-HI2WzN3tmoknG2N7Zx0ZpBNcH9s42Le9nG5_XJH_6wB5vu1KpEFaj1tKTTjkKd15NIWf4GQB_haw</recordid><startdate>20091001</startdate><enddate>20091001</enddate><creator>Budoff, Matthew J., MD, FACC, FAHA</creator><creator>McClelland, Robyn L., PhD</creator><creator>Nasir, Khurram, MD, MPH</creator><creator>Greenland, Philip, MD</creator><creator>Kronmal, Richard A., PhD</creator><creator>Kondos, George T., MD</creator><creator>Shea, Steven, MD</creator><creator>Lima, Joao A.C., MD</creator><creator>Blumenthal, Roger S., MD</creator><general>Mosby, Inc</general><general>Mosby</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7QP</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20091001</creationdate><title>Cardiovascular events with absent or minimal coronary calcification: The Multi-Ethnic Study of Atherosclerosis (MESA)</title><author>Budoff, Matthew J., MD, FACC, FAHA ; McClelland, Robyn L., PhD ; Nasir, Khurram, MD, MPH ; Greenland, Philip, MD ; Kronmal, Richard A., PhD ; Kondos, George T., MD ; Shea, Steven, MD ; Lima, Joao A.C., MD ; Blumenthal, Roger S., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c593t-ada1667244616e3189187794f30825fe5544a5afb0306fe44ddbae9498e0c3a23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Age Distribution</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Atherosclerosis (general aspects, experimental research)</topic><topic>Atherosclerosis - blood</topic><topic>Atherosclerosis - diagnosis</topic><topic>Atherosclerosis - ethnology</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Calcinosis - blood</topic><topic>Calcinosis - diagnosis</topic><topic>Calcinosis - ethnology</topic><topic>Calcium - blood</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Carotid Arteries - diagnostic imaging</topic><topic>Cholesterol</topic><topic>Coronary Artery Disease - blood</topic><topic>Coronary Artery Disease - diagnosis</topic><topic>Coronary Artery Disease - ethnology</topic><topic>Coronary heart disease</topic><topic>Ethnic Groups</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Incidence</topic><topic>Low density lipoprotein</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Older people</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Sex Distribution</topic><topic>Time Factors</topic><topic>Tomography, X-Ray Computed</topic><topic>Ultrasonography</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Budoff, Matthew J., MD, FACC, FAHA</creatorcontrib><creatorcontrib>McClelland, Robyn L., PhD</creatorcontrib><creatorcontrib>Nasir, Khurram, MD, MPH</creatorcontrib><creatorcontrib>Greenland, Philip, MD</creatorcontrib><creatorcontrib>Kronmal, Richard A., PhD</creatorcontrib><creatorcontrib>Kondos, George T., MD</creatorcontrib><creatorcontrib>Shea, Steven, MD</creatorcontrib><creatorcontrib>Lima, Joao A.C., MD</creatorcontrib><creatorcontrib>Blumenthal, Roger S., MD</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>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Budoff, Matthew J., MD, FACC, FAHA</au><au>McClelland, Robyn L., PhD</au><au>Nasir, Khurram, MD, MPH</au><au>Greenland, Philip, MD</au><au>Kronmal, Richard A., PhD</au><au>Kondos, George T., MD</au><au>Shea, Steven, MD</au><au>Lima, Joao A.C., MD</au><au>Blumenthal, Roger S., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cardiovascular events with absent or minimal coronary calcification: The Multi-Ethnic Study of Atherosclerosis (MESA)</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2009-10-01</date><risdate>2009</risdate><volume>158</volume><issue>4</issue><spage>554</spage><epage>561</epage><pages>554-561</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Background Elevated coronary artery calcium (CAC) is a marker for increase risk of coronary heart disease (CHD). Although most CHD events occur among individuals with advanced CAC, CHD can also occur in individuals with little or no calcified plaque. In this study, we sought to evaluate the characteristics associated with incident CHD events in the setting of minimal (score ≤10) or absent CAC (score of zero). Methods Asymptomatic participants in the MESA (N = 6,809) were followed for occurrence of all CHD events (including myocardial infarction, angina, resuscitated cardiac arrest, or CHD death) and hard CHD events (myocardial infarction or CHD death). Time to incident CHD was modeled using age-and gender-adjusted Cox regression. Results The final study population consisted of 3,923 MESA asymptomatic participants (mean age 58 ± 9 years, 39% males) who had CAC scores of 0 to 10. Overall, no detectable CAC was seen in 3415 individuals, whereas 508 had CAC scores of 1 to 10. During follow-up (median 4.1 years), there were 16 incident hard events and 28 all CHD events in individuals with absent or minimal CAC. In age-, gender-, race-, and CHD risk factor-adjusted analysis, minimal CAC (1-10) was associated with an estimated 3-fold greater risk of a hard CHD event (HR 3.23, 95% CI 1.17-8.95) or of all CHD event (HR 3.66, 95% CI 1.71-7.85) compared to those with CAC = 0. Former smoking (HR 3.57, 95% CI 1.08-11.77), current smoking (HR 4.93, 95% CI 1.20-20.30), and diabetes (HR 3.09, 95% CI 1.07-8.93) were significant risk factors for events in those with CAC = 0. Conclusion Asymptomatic persons with absent or minimal CAC are at very low risk of future cardiovascular events. Individuals with minimal CAC (1-10) were significantly increased to 3-fold increased risk for incident CHD events relative to those with CAC scores of zero.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>19781414</pmid><doi>10.1016/j.ahj.2009.08.007</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | The American heart journal, 2009-10, Vol.158 (4), p.554-561 |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present); ProQuest Central UK/Ireland |
| subjects | Age Distribution Aged Aged, 80 and over Atherosclerosis (general aspects, experimental research) Atherosclerosis - blood Atherosclerosis - diagnosis Atherosclerosis - ethnology Biological and medical sciences Blood and lymphatic vessels Calcinosis - blood Calcinosis - diagnosis Calcinosis - ethnology Calcium - blood Cardiology. Vascular system Cardiovascular Cardiovascular disease Carotid Arteries - diagnostic imaging Cholesterol Coronary Artery Disease - blood Coronary Artery Disease - diagnosis Coronary Artery Disease - ethnology Coronary heart disease Ethnic Groups Female Follow-Up Studies Heart Heart attacks Humans Incidence Low density lipoprotein Male Medical sciences Middle Aged Older people Prognosis Prospective Studies Risk Factors Severity of Illness Index Sex Distribution Time Factors Tomography, X-Ray Computed Ultrasonography United States - epidemiology |
| title | Cardiovascular events with absent or minimal coronary calcification: The Multi-Ethnic Study of Atherosclerosis (MESA) |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-10T13%3A53%3A35IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Cardiovascular%20events%20with%20absent%20or%20minimal%20coronary%20calcification:%20The%20Multi-Ethnic%20Study%20of%20Atherosclerosis%20(MESA)&rft.jtitle=The%20American%20heart%20journal&rft.au=Budoff,%20Matthew%20J.,%20MD,%20FACC,%20FAHA&rft.date=2009-10-01&rft.volume=158&rft.issue=4&rft.spage=554&rft.epage=561&rft.pages=554-561&rft.issn=0002-8703&rft.eissn=1097-6744&rft.coden=AHJOA2&rft_id=info:doi/10.1016/j.ahj.2009.08.007&rft_dat=%3Cproquest_pubme%3E67670350%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1504612676&rft_id=info:pmid/19781414&rft_els_id=S0002870309006188&rfr_iscdi=true |