Abstract 12: Volume of Calcium in the Descending Thoracic Aorta Predicts All Cause Mortality Beyond Coronary Artery Calcium: The Multi-Ethnic Study of Atherosclerosis

2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Isac C Thomas ◽  
Matthew A Allison ◽  
Nketi I Forbang ◽  
Erin D Michos ◽  
WT Longstreth ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Thoracic Aorta ◽  
Coronary Artery Calcium ◽  
Regression Models ◽  
Cardiac Ct ◽  
Descending Thoracic Aorta ◽  
Predictive Values ◽  
Ethnic Study ◽  
All Cause Mortality

Introduction: Coronary artery calcium (CAC) volume and density differentially predict incident cardiovascular disease (CVD), with CAC density inversely associated with these outcomes. Whether similar associations exist between descending thoracic aortic calcium (DTAC) volume and density and all cause mortality (ACM) are unknown. We hypothesized that DTAC volume and density predict ACM independently of CAC. Methods: The Multi-Ethnic Study of Atherosclerosis enrolled 6,814 participants free of clinical CVD at baseline and followed them for incident adverse events. Cardiac CT at baseline visualized the segment of the descending thoracic aorta posterior to the heart. Only participants with prevalent DTAC were included (necessary to evaluate DTAC density). DTAC and CAC volumes were natural log transformed to adjust for skewness. Cox regression models estimated the associations of DTAC volume and density with ACM after adjustment for age, gender, ethnicity, CVD risk factors, statin use, and CAC volume and density. The incremental predictive values of DTAC volume and density were evaluated by area under receiver operating characteristic (AUC) curves. Results: Of the total cohort, 1,850 participants (27%) had prevalent DTAC and 491 deaths occurred over 10.3 years. In separate regression models, DTAC volume was independently associated with ACM after adjustment for CAC volume (HR 1.21 [95% CI 1.09-1.35]) and additional adjustment for CAC density (1.18 ([1.06-1.32]). After the same adjustments, DTAC density was not significantly associated with ACM (0.94 [0.84-1.06]). The AUC for the base Model 1 (risk factors + CAC volume) was 0.706 (0.680-0.732), which increased to 0.716 (0.690-0.742) with the addition of DTAC volume in Model 2 (p=0.03 compared to Model 1). Further addition of DTAC density in Model 3 did not improve the AUC significantly (0.717 [0.692-0.743], p=0.23 compared to Model 2). Conclusions: In a cohort free of baseline clinical CVD, DTAC visualized on cardiac CT was common. When DTAC was present, DTAC volume (but not density) was independently associated with ACM. DTAC volume also significantly improved ACM risk prediction beyond risk factors and CAC volume.

Abstract P104: Higher Leptin Levels Are Associated With Increased Odds Of Coronary Artery Calcium Progression: The Multi-ethnic Study Of Atherosclerosis

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Bhavya Varma ◽  
Oluseye Ogunmoroti ◽  
Chiadi Ndumele ◽  
Di Zhao ◽  
Moyses Szklo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Cardiac Ct ◽  
Subclinical Atherosclerosis ◽  
Community Dwelling ◽  
Ct Scans ◽  
Agatston Score ◽  
Cvd Risk ◽  
Ethnic Study ◽  
History Of

Background: Adipokines are secreted by adipose tissue, play a role in cardiometabolic pathways, and have differing associations with cardiovascular disease (CVD). Coronary artery calcium (CAC) and its progression indicate subclinical atherosclerosis and prognosticate CVD risk. However the association of adipokines with CAC progression is not well established. We examined the association of adipokines with the odds of a history of CAC progression in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: We performed an analysis of 1,904 community dwelling adults free of clinical CVD in MESA. Participants underwent measurement of serum adipokines [leptin, resistin and adiponectin] at visits 2 or 3 (randomly assigned) and a contemporaneous cardiac CT scan at same visit. Participants also had a prior cardiac CT at visit 1, at a median of 2.4 years earlier. On both CTs, CAC was quantified by Agatston score. We defined a history of CAC progression between the CT scans at visit 1 and at visit 2 or 3 as those with >0 Agatston units of change per year (and compared to those with ≤0 units of change per year). We used logistic regression to examine the odds of having a history of CAC progression by adipokine tertiles using progressively adjusted models. Results: The mean participant age was 65 (10) years; 50% were women, 40% White, 13% Chinese, 21% Black and 26% Hispanic. The prevalences of CAC at visits 1 and 2/3 were 49% and 58%, respectively. There were 1,001 (53%) who had CAC progression between the 2 CT scans. In demographic-adjusted models (model 1, Table), higher leptin and lower adiponectin were associated with increased odds of prior CAC progression. In models fully adjusted for BMI and other CVD risk factors (model 3), only the highest tertile of leptin remained associated with a greater odds of prior CAC progression [OR 1.55 (95% CI 1.04, 2.30)]. Conclusions: Higher leptin levels were independently associated with a history of CAC progression. Atherosclerosis progression may be one mechanism through which leptin confers increased CVD risk

Prognostic Value of Cardiac Risk Factors and Coronary Artery Calcium Screening for All-Cause Mortality

Radiology ◽  
2003 ◽  
Vol 228 (3) ◽  
pp. 826-833 ◽  
Author(s):  
Leslee J. Shaw ◽  
Paolo Raggi ◽  
Enrique Schisterman ◽  
Daniel S. Berman ◽  
Tracy Q. Callister
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Prognostic Value ◽  
Cardiac Risk ◽  
Cardiac Risk Factors ◽  
All Cause Mortality

Abstract MP04: Sex Hormones and 10 Year Progression of Coronary Artery Calcium Among Post-Menopausal Women in the Multi-Ethnic Study of Atherosclerosis

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Vinita Subramanya ◽  
Di Zhao ◽  
Pamela Ouyang ◽  
Wendy Ying ◽  
Dhananjay Vaidya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Sex Hormones ◽  
Coronary Artery Calcium ◽  
Cardiac Ct ◽  
Sex Hormone ◽  
Cvd Risk ◽  
Menopausal Women ◽  
Androgenic Hormone ◽  
Post Menopausal

Background: Cardiovascular disease (CVD) is the leading cause of death in women. Sex differences in risk factors, prevalence and mortality suggest the involvement of sex hormones in disease processes. Coronary artery calcium (CAC) is a marker of subclinical atherosclerosis and its progression. CAC is prognostic of CVD risk, independent of traditional risk factors, even among low-risk women. We hypothesized that a more androgenic hormone pattern will predict CAC progression over 10 years in post-menopausal women. Methods: We studied 2759 post-menopausal women, aged 45-84 years, participating in MESA who underwent serum sex hormone measurement and a cardiac CT scan for CAC at baseline (2000-2002). Among these, 2427 women had up to 3 follow-up cardiac CT scans at subsequent visits spanning 10 years. CAC was assessed by Agatson units. CAC and sex hormones were log-transformed for analysis. Using multivariable-adjusted Poisson and linear mixed effects models, we tested the longitudinal associations of testosterone (T), free T, dehydroepiandrosterone (DHEA), estradiol (E2), and sex hormone binding globulin (SHBG) with prevalent CAC and progression of CAC over 10 years. Results: At baseline, average age was 65 years, 46% had prevalent CAC and 32% were using hormone therapy (HT). Cross-sectionally, there were no associations between sex hormones and prevalent CAC. After adjustment for demographics, lifestyle factors and use of HT, higher levels of free T and lower levels of SHBG were associated with an increase in CAC progression over 10 years ( Table, Model 2). These associations remained statistically significant after adjusting for potential mediating cardiovascular risk factors (Model 3) and in sensitivity analyses excluding women on HT. Conclusion: A more androgenic hormone profile of higher free T and lower SHBG is associated with a greater CAC progression over 10 years in post-menopausal women. Sex hormone levels may help identify women at increased CVD risk who may benefit from other risk reduction strategies.

Abstract 045: Leisure Time Physical Activity is Associated With Higher Coronary Artery Calcium Density: The Multi-Ethnic Study of Atherosclerosis

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Isac C Thomas ◽  
Matthew Allison ◽  
Nketi Forbang ◽  
Michelle Takemoto ◽  
Erin Michos ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
Statistical Significance ◽  
Unexpected Finding ◽  
Cvd Risk ◽  
Ethnic Study

Introduction: Leisure-time physical activity (LTPA) has favorable effects on many risk factors for cardiovascular disease (CVD). Paradoxically, LTPA has also been associated with higher amounts of coronary artery calcium (CAC) in athletes. Recently, a higher density of CAC was shown to significantly mitigate the risk of CVD associated with a given volume of CAC. The effects of LTPA and non-LTPA on the density and volume components of CAC among individuals with calcified coronary atherosclerosis are unknown. Methods: We evaluated 3,398 participants from the Multi-Ethnic Study of Atherosclerosis with prevalent CAC (50% of cohort). CAC was assessed via cardiac computed tomography, while physical activity was assessed via questionnaire and categorized by quintiles of moderate and vigorous LTPA (e.g. exercise) and non-LTPA (e.g. work). Multiple linear regression with mutual adjustment for LTPA, non-LTPA, demographics, and CVD risk factors was performed. Results: Mean age of the sample was 66 years, 58% were male, 44% were Caucasian, 24% were African-American, 20% were Hispanic, and 12% were Chinese-American. Compared to the lower four quintiles, LTPA above the threshold of 2567 MET-minutes/week (quintile 5) was associated with 0.057 (0.008, 0.105) higher CAC density-units after full adjustment. LTPA at any level was not associated with CAC volume. Conversely, non-LTPA was associated with both lower CAC density and higher CAC volume in a stepwise fashion, with the highest quintile meeting statistical significance for both (see Table). Conclusions: The highest quintile of LTPA was associated with higher CAC density but not higher CAC volume, suggesting a possible explanation for high CAC scores in athletes with favorable CVD risk factor profiles. Non-LTPA was associated with a less favorable CAC composition after adjustment for LTPA, an unexpected finding that merits further investigation.

scholarly journals Risk Factors for Long‐Term Coronary Artery Calcium Progression in the Multi‐Ethnic Study of Atherosclerosis

2015 ◽  
Vol 4 (8) ◽  
Author(s):  
Amanda J. Gassett ◽  
Lianne Sheppard ◽  
Robyn L. McClelland ◽  
Casey Olives ◽  
Richard Kronmal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Ethnic Study
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