Predicting Long-Term Absence of Coronary Artery Calcium in Metabolic Syndrome and Diabetes: The MESA Study
The purpose of this study was to identify predictors of healthy arterial aging (long-term coronary artery calcification [CAC] of 0) among individuals with metabolic syndrome (MetS) or type 2 diabetes (T2D), which may improve primary prevention strategies. Individuals with MetS or T2D have a heteroge...
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| Veröffentlicht in: | JACC. Cardiovascular imaging 2021-01, Vol.14 (1), p.219-229 |
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| creator | Razavi, Alexander C Wong, Nathan Budoff, Matthew Bazzano, Lydia A Kelly, Tanika N He, Jiang Fernandez, Camilo Lima, Joao Polak, Joseph F Mongraw-Chaffin, Morgana deFilippi, Chris Szklo, Moyses Bertoni, Alain G Blumenthal, Roger S Blaha, Michael J Whelton, Seamus P |
| description | The purpose of this study was to identify predictors of healthy arterial aging (long-term coronary artery calcification [CAC] of 0) among individuals with metabolic syndrome (MetS) or type 2 diabetes (T2D), which may improve primary prevention strategies.
Individuals with MetS or T2D have a heterogeneously increased risk of atherosclerotic cardiovascular disease and not all have a high-intermediate risk.
We included 574 participants from the MESA (Multi-Ethnic Study of Atherosclerosis) with MetS or T2D who had CAC=0 at baseline and a repeat CAC scan 10 years later. Multivariable logistic regression assessed the association of traditional and novel atherosclerotic cardiovascular disease risk factors and the MetS severity score (based on the 5 MetS criteria) with healthy arterial aging.
The mean age of participants was 58.9 years, 67% were women, 422 participants had MetS, and 152 had T2D. The proportion with long-term CAC=0 was similar for MetS (42%) and T2D (44%). A younger age was the only individual low/normal traditional risk factor associated with an increased likelihood of long-term CAC=0 (odds ratio [OR]: 1.50; 95% confidence interval [CI]: 1.22 to 1.85 per 10-years younger). The strongest associations of nontraditional risk factors were observed for an absence of thoracic calcification (OR: 2.42; 95% CI: 1.24 to 4.72), absence of carotid plaque (OR: 1.81; 95% CI: 1.25 to 2.61), and among persons with a high sensitivity troponin |
| doi_str_mv | 10.1016/j.jcmg.2020.06.047 |
| format | Article |
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Individuals with MetS or T2D have a heterogeneously increased risk of atherosclerotic cardiovascular disease and not all have a high-intermediate risk.
We included 574 participants from the MESA (Multi-Ethnic Study of Atherosclerosis) with MetS or T2D who had CAC=0 at baseline and a repeat CAC scan 10 years later. Multivariable logistic regression assessed the association of traditional and novel atherosclerotic cardiovascular disease risk factors and the MetS severity score (based on the 5 MetS criteria) with healthy arterial aging.
The mean age of participants was 58.9 years, 67% were women, 422 participants had MetS, and 152 had T2D. The proportion with long-term CAC=0 was similar for MetS (42%) and T2D (44%). A younger age was the only individual low/normal traditional risk factor associated with an increased likelihood of long-term CAC=0 (odds ratio [OR]: 1.50; 95% confidence interval [CI]: 1.22 to 1.85 per 10-years younger). The strongest associations of nontraditional risk factors were observed for an absence of thoracic calcification (OR: 2.42; 95% CI: 1.24 to 4.72), absence of carotid plaque (OR: 1.81; 95% CI: 1.25 to 2.61), and among persons with a high sensitivity troponin <3 ng/ml (OR: 1.55; 95% CI: 1.01 to 2.38). In addition, persons with the lowest quartile MetS severity score had a substantially higher odds of healthy long-term CAC=0 (OR: 2.71; 95% CI: 1.27 to 5.76).
More than 40% of adults with MetS or T2D and baseline CAC=0 had long-term absence of CAC, which was most strongly associated with an absence of extracoronary atherosclerosis and a low MetS score. An optimal overall cardiovascular profile appears to be more important than an ideal value of any individual risk factor to maintain healthy arterial aging.</description><identifier>ISSN: 1936-878X</identifier><identifier>EISSN: 1876-7591</identifier><identifier>DOI: 10.1016/j.jcmg.2020.06.047</identifier><identifier>PMID: 33129732</identifier><language>eng</language><publisher>United States</publisher><subject>Calcium ; Coronary Artery Disease ; Coronary Vessels ; Diabetes Mellitus, Type 2 ; Female ; Humans ; Male ; Metabolic Syndrome ; Middle Aged ; Predictive Value of Tests ; Risk Factors ; Vascular Calcification</subject><ispartof>JACC. Cardiovascular imaging, 2021-01, Vol.14 (1), p.219-229</ispartof><rights>Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33129732$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Razavi, Alexander C</creatorcontrib><creatorcontrib>Wong, Nathan</creatorcontrib><creatorcontrib>Budoff, Matthew</creatorcontrib><creatorcontrib>Bazzano, Lydia A</creatorcontrib><creatorcontrib>Kelly, Tanika N</creatorcontrib><creatorcontrib>He, Jiang</creatorcontrib><creatorcontrib>Fernandez, Camilo</creatorcontrib><creatorcontrib>Lima, Joao</creatorcontrib><creatorcontrib>Polak, Joseph F</creatorcontrib><creatorcontrib>Mongraw-Chaffin, Morgana</creatorcontrib><creatorcontrib>deFilippi, Chris</creatorcontrib><creatorcontrib>Szklo, Moyses</creatorcontrib><creatorcontrib>Bertoni, Alain G</creatorcontrib><creatorcontrib>Blumenthal, Roger S</creatorcontrib><creatorcontrib>Blaha, Michael J</creatorcontrib><creatorcontrib>Whelton, Seamus P</creatorcontrib><title>Predicting Long-Term Absence of Coronary Artery Calcium in Metabolic Syndrome and Diabetes: The MESA Study</title><title>JACC. Cardiovascular imaging</title><addtitle>JACC Cardiovasc Imaging</addtitle><description>The purpose of this study was to identify predictors of healthy arterial aging (long-term coronary artery calcification [CAC] of 0) among individuals with metabolic syndrome (MetS) or type 2 diabetes (T2D), which may improve primary prevention strategies.
Individuals with MetS or T2D have a heterogeneously increased risk of atherosclerotic cardiovascular disease and not all have a high-intermediate risk.
We included 574 participants from the MESA (Multi-Ethnic Study of Atherosclerosis) with MetS or T2D who had CAC=0 at baseline and a repeat CAC scan 10 years later. Multivariable logistic regression assessed the association of traditional and novel atherosclerotic cardiovascular disease risk factors and the MetS severity score (based on the 5 MetS criteria) with healthy arterial aging.
The mean age of participants was 58.9 years, 67% were women, 422 participants had MetS, and 152 had T2D. The proportion with long-term CAC=0 was similar for MetS (42%) and T2D (44%). A younger age was the only individual low/normal traditional risk factor associated with an increased likelihood of long-term CAC=0 (odds ratio [OR]: 1.50; 95% confidence interval [CI]: 1.22 to 1.85 per 10-years younger). The strongest associations of nontraditional risk factors were observed for an absence of thoracic calcification (OR: 2.42; 95% CI: 1.24 to 4.72), absence of carotid plaque (OR: 1.81; 95% CI: 1.25 to 2.61), and among persons with a high sensitivity troponin <3 ng/ml (OR: 1.55; 95% CI: 1.01 to 2.38). In addition, persons with the lowest quartile MetS severity score had a substantially higher odds of healthy long-term CAC=0 (OR: 2.71; 95% CI: 1.27 to 5.76).
More than 40% of adults with MetS or T2D and baseline CAC=0 had long-term absence of CAC, which was most strongly associated with an absence of extracoronary atherosclerosis and a low MetS score. An optimal overall cardiovascular profile appears to be more important than an ideal value of any individual risk factor to maintain healthy arterial aging.</description><subject>Calcium</subject><subject>Coronary Artery Disease</subject><subject>Coronary Vessels</subject><subject>Diabetes Mellitus, Type 2</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Metabolic Syndrome</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>Risk Factors</subject><subject>Vascular Calcification</subject><issn>1936-878X</issn><issn>1876-7591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkN1KwzAcxYMoTqcv4IXkBVqTJk0aL4RS5wdsKGyCdyVt_-lS2nSknbC3t-AHenUOHM4PzkHoipKQEipumrApuzqMSERCIkLC5RE6o4kUgYwVPZ68YiJIZPI-Q-fD0BAiiODyFM0Yo5GSLDpDzauHypajdTVe9q4ONuA7nBYDuBJwb3DW-95pf8CpH2GSTLel3XfYOryCURd9a0u8PrjK9x1g7Sp8b3UBIwy3eLMFvFqsU7we99XhAp0Y3Q5w-a1z9Paw2GRPwfLl8TlLl8GOJnQMSsYSwxUrueYGGBSRSSIVqcJoRSHmhYgTygyHOCKGUw1GUCl5kQitjTGczdHdF3e3LzqoSnCj122-87abduS9tvn_xNltXvcfuZRKKC4nwPVfwG_z5zX2CWNLciw</recordid><startdate>20210101</startdate><enddate>20210101</enddate><creator>Razavi, Alexander C</creator><creator>Wong, Nathan</creator><creator>Budoff, Matthew</creator><creator>Bazzano, Lydia A</creator><creator>Kelly, Tanika N</creator><creator>He, Jiang</creator><creator>Fernandez, Camilo</creator><creator>Lima, Joao</creator><creator>Polak, Joseph F</creator><creator>Mongraw-Chaffin, Morgana</creator><creator>deFilippi, Chris</creator><creator>Szklo, Moyses</creator><creator>Bertoni, Alain G</creator><creator>Blumenthal, Roger S</creator><creator>Blaha, Michael J</creator><creator>Whelton, Seamus P</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>5PM</scope></search><sort><creationdate>20210101</creationdate><title>Predicting Long-Term Absence of Coronary Artery Calcium in Metabolic Syndrome and Diabetes: The MESA Study</title><author>Razavi, Alexander C ; Wong, Nathan ; Budoff, Matthew ; Bazzano, Lydia A ; Kelly, Tanika N ; He, Jiang ; Fernandez, Camilo ; Lima, Joao ; Polak, Joseph F ; Mongraw-Chaffin, Morgana ; deFilippi, Chris ; Szklo, Moyses ; Bertoni, Alain G ; Blumenthal, Roger S ; Blaha, Michael J ; Whelton, Seamus P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p181t-c338f493c4a4fe3eb2f82929bfa91e54b65813f4e520f41aef61774b86aafff43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Calcium</topic><topic>Coronary Artery Disease</topic><topic>Coronary Vessels</topic><topic>Diabetes Mellitus, Type 2</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Metabolic Syndrome</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>Risk Factors</topic><topic>Vascular Calcification</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Razavi, Alexander C</creatorcontrib><creatorcontrib>Wong, Nathan</creatorcontrib><creatorcontrib>Budoff, Matthew</creatorcontrib><creatorcontrib>Bazzano, Lydia A</creatorcontrib><creatorcontrib>Kelly, Tanika N</creatorcontrib><creatorcontrib>He, Jiang</creatorcontrib><creatorcontrib>Fernandez, Camilo</creatorcontrib><creatorcontrib>Lima, Joao</creatorcontrib><creatorcontrib>Polak, Joseph F</creatorcontrib><creatorcontrib>Mongraw-Chaffin, Morgana</creatorcontrib><creatorcontrib>deFilippi, Chris</creatorcontrib><creatorcontrib>Szklo, Moyses</creatorcontrib><creatorcontrib>Bertoni, Alain G</creatorcontrib><creatorcontrib>Blumenthal, Roger S</creatorcontrib><creatorcontrib>Blaha, Michael J</creatorcontrib><creatorcontrib>Whelton, Seamus P</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>JACC. Cardiovascular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Razavi, Alexander C</au><au>Wong, Nathan</au><au>Budoff, Matthew</au><au>Bazzano, Lydia A</au><au>Kelly, Tanika N</au><au>He, Jiang</au><au>Fernandez, Camilo</au><au>Lima, Joao</au><au>Polak, Joseph F</au><au>Mongraw-Chaffin, Morgana</au><au>deFilippi, Chris</au><au>Szklo, Moyses</au><au>Bertoni, Alain G</au><au>Blumenthal, Roger S</au><au>Blaha, Michael J</au><au>Whelton, Seamus P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predicting Long-Term Absence of Coronary Artery Calcium in Metabolic Syndrome and Diabetes: The MESA Study</atitle><jtitle>JACC. Cardiovascular imaging</jtitle><addtitle>JACC Cardiovasc Imaging</addtitle><date>2021-01-01</date><risdate>2021</risdate><volume>14</volume><issue>1</issue><spage>219</spage><epage>229</epage><pages>219-229</pages><issn>1936-878X</issn><eissn>1876-7591</eissn><abstract>The purpose of this study was to identify predictors of healthy arterial aging (long-term coronary artery calcification [CAC] of 0) among individuals with metabolic syndrome (MetS) or type 2 diabetes (T2D), which may improve primary prevention strategies.
Individuals with MetS or T2D have a heterogeneously increased risk of atherosclerotic cardiovascular disease and not all have a high-intermediate risk.
We included 574 participants from the MESA (Multi-Ethnic Study of Atherosclerosis) with MetS or T2D who had CAC=0 at baseline and a repeat CAC scan 10 years later. Multivariable logistic regression assessed the association of traditional and novel atherosclerotic cardiovascular disease risk factors and the MetS severity score (based on the 5 MetS criteria) with healthy arterial aging.
The mean age of participants was 58.9 years, 67% were women, 422 participants had MetS, and 152 had T2D. The proportion with long-term CAC=0 was similar for MetS (42%) and T2D (44%). A younger age was the only individual low/normal traditional risk factor associated with an increased likelihood of long-term CAC=0 (odds ratio [OR]: 1.50; 95% confidence interval [CI]: 1.22 to 1.85 per 10-years younger). The strongest associations of nontraditional risk factors were observed for an absence of thoracic calcification (OR: 2.42; 95% CI: 1.24 to 4.72), absence of carotid plaque (OR: 1.81; 95% CI: 1.25 to 2.61), and among persons with a high sensitivity troponin <3 ng/ml (OR: 1.55; 95% CI: 1.01 to 2.38). In addition, persons with the lowest quartile MetS severity score had a substantially higher odds of healthy long-term CAC=0 (OR: 2.71; 95% CI: 1.27 to 5.76).
More than 40% of adults with MetS or T2D and baseline CAC=0 had long-term absence of CAC, which was most strongly associated with an absence of extracoronary atherosclerosis and a low MetS score. An optimal overall cardiovascular profile appears to be more important than an ideal value of any individual risk factor to maintain healthy arterial aging.</abstract><cop>United States</cop><pmid>33129732</pmid><doi>10.1016/j.jcmg.2020.06.047</doi><tpages>11</tpages></addata></record> |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present); EZB-FREE-00999 freely available EZB journals |
| subjects | Calcium Coronary Artery Disease Coronary Vessels Diabetes Mellitus, Type 2 Female Humans Male Metabolic Syndrome Middle Aged Predictive Value of Tests Risk Factors Vascular Calcification |
| title | Predicting Long-Term Absence of Coronary Artery Calcium in Metabolic Syndrome and Diabetes: The MESA Study |
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