scholarly journals Sex Differences in Coronary Artery Calcium and Mortality from Coronary Heart Disease, Cardiovascular Disease, and All Causes in Adults with Diabetes: The Coronary Calcium Consortium

2020 ◽  
Author(s):  
Nathan D Wong ◽  
Amber R Cordola Hsu ◽  
Alan Rozanski ◽  
Leslee J Shaw ◽  
Seamus P. Whelton ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Cox Regression ◽  
Total Mortality ◽  
Design And Methods ◽  
Cvd Mortality

<b>Objective:</b> While diabetes mellitus (DM) has been previously noted to be a stronger risk factor for cardiovascular disease (CVD) in women compared to men, it is not clear if this still the case. Coronary artery calcium (CAC) predicts coronary heart disease (CHD) and CVD in persons with DM; however, its sex-specific impact is less defined. We compared the relation of CAC in women versus men with DM for total, CVD, and CHD mortality. <p><b>Research Design and Methods:</b> We studied adults with DM from a large registry of patients with CAC scanning with mortality follow-up over 11.5 years. Cox regression examined the relation of CAC with mortality endpoints. </p> <p><b>Results:</b> Among 4,503 adults with DM (32.5% women) aged 21-93 years, 61.2% of women and 80.4% of men had CAC>0. Total, CVD, and CHD mortality rates were directly related to CAC; women had higher total and CVD death rates than men when CAC>100. Age and risk factor-adjusted hazard ratios (HRs) per log unit CAC were higher among women versus men for total (1.36 vs. 1.21) and CVD mortality (1.67 vs. 1.33) (interaction p=0.01 for both) but similar for CHD mortality (1.53 and 1.48). For CVD mortality, HR’s with CAC scores of 101-400 and >400 were 3.67 and 6.27, respectively for women and 1.63 and 3.48, respectively for men (interaction p=0.04). For total mortality HRs were 2.56 and 4.05 for women, respectively, and 1.88 and 2.66 for men, respectively (interaction p=0.01). </p> <p><b>Conclusion:</b> CAC predicts CHD, CVD, and all-cause mortality in patients with DM; however, greater CAC predicts CVD and total mortality more strongly in women.<b> </b></p>

scholarly journals Sex Differences in Coronary Artery Calcium and Mortality from Coronary Heart Disease, Cardiovascular Disease, and All Causes in Adults with Diabetes: The Coronary Calcium Consortium

2020 ◽  
Author(s):  
Nathan D Wong ◽  
Amber R Cordola Hsu ◽  
Alan Rozanski ◽  
Leslee J Shaw ◽  
Seamus P. Whelton ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Cox Regression ◽  
Total Mortality ◽  
Design And Methods ◽  
Cvd Mortality

<b>Objective:</b> While diabetes mellitus (DM) has been previously noted to be a stronger risk factor for cardiovascular disease (CVD) in women compared to men, it is not clear if this still the case. Coronary artery calcium (CAC) predicts coronary heart disease (CHD) and CVD in persons with DM; however, its sex-specific impact is less defined. We compared the relation of CAC in women versus men with DM for total, CVD, and CHD mortality. <p><b>Research Design and Methods:</b> We studied adults with DM from a large registry of patients with CAC scanning with mortality follow-up over 11.5 years. Cox regression examined the relation of CAC with mortality endpoints. </p> <p><b>Results:</b> Among 4,503 adults with DM (32.5% women) aged 21-93 years, 61.2% of women and 80.4% of men had CAC>0. Total, CVD, and CHD mortality rates were directly related to CAC; women had higher total and CVD death rates than men when CAC>100. Age and risk factor-adjusted hazard ratios (HRs) per log unit CAC were higher among women versus men for total (1.36 vs. 1.21) and CVD mortality (1.67 vs. 1.33) (interaction p=0.01 for both) but similar for CHD mortality (1.53 and 1.48). For CVD mortality, HR’s with CAC scores of 101-400 and >400 were 3.67 and 6.27, respectively for women and 1.63 and 3.48, respectively for men (interaction p=0.04). For total mortality HRs were 2.56 and 4.05 for women, respectively, and 1.88 and 2.66 for men, respectively (interaction p=0.01). </p> <p><b>Conclusion:</b> CAC predicts CHD, CVD, and all-cause mortality in patients with DM; however, greater CAC predicts CVD and total mortality more strongly in women.<b> </b></p>

Abstract P375: Coronary Artery Structural Remodeling by Computed Tomography and Cardiovascular Disease; the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
J J Carr ◽  
Yaorong Ge ◽  
Edmond K Kabagambe ◽  
James G Terry ◽  
Donald Lloyd-Jones ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
White Male ◽  
Imaging Biomarker ◽  
Cross Sectional ◽  
Pericardial Fat

Background: Glagov identified cross-sectional enlargement and maintenance of the lumen of the coronary artery (CA) in post-mortem studies as an early feature of atherosclerotic coronary heart disease (CHD) that precedes the development of stenosis, coronary artery calcium (CAC) and plaque rupture. This structural change in the CA wall has been termed positive remodeling. We hypothesized that larger CA cross-sectional areas, consistent with positively remodeled CA, is associated with prevalent or soon-to-be incident coronary heart disease (CHD) and cardiovascular disease (CVD) events. Methods: In 2946 black and white male and female CARDIA participants aged 42-56 years, who had thin-slice (<1 mm), ECG gated, non-contrast coronary CT in 2010-2011, we measured CA cross-sectional area (CSA) in the proximal epicardial CA at 24 pre-specified locations. The mean of all measurements was calculated to provide a summary of all CA (CA CSA_all ). We performed logistic regression with medical-record adjudicated CVD prevalence (n=96) or incidence in the following 3 years (n=27) as the outcome, predicted from this estimate of positive remodeling adjusting for age, race, sex, presence of coronary artery calcium (CAC), and amount of pericardial fat as covariates. Results: CA CSA_all had a mean ± SD 21.2 ± 6.7 mm 2 . The adjusted odds ratio (OR) for having any CVD was 1.06 (95% CI 1.03-1.09, p<0.0001) per mm 2 (Table). ORs for CVD increased across quartiles of CA CSA_all . Corresponding OR for any coronary heart disease (n=66) was not significant, but was significant for stroke (n=42) and for heart failure (n=27). Further adjustment for traditional risk factors assessed in 2010-2011 did not alter these estimates substantially. Conclusion: Individuals with larger CA cross-sectional areas had increased odds of CVD, stroke, and heart failure, but not CHD, independent of CAC and pericardial fat. CA CSA_all may be an imaging biomarker of coronary positive remodeling and provide new insight into progression from subclinical to premature clinical CVD.

scholarly journals Thoracic Aortic Calcium Versus Coronary Artery Calcium for the Prediction of Coronary Heart Disease and Cardiovascular Disease Events

2009 ◽  
Vol 2 (3) ◽  
pp. 319-326 ◽  
Author(s):  
Nathan D. Wong ◽  
Heidi Gransar ◽  
Leslee Shaw ◽  
Donna Polk ◽  
Johanna H. Moon ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Artery Calcium

scholarly journals Coronary artery calcium as a predictor of coronary heart disease, cardiovascular disease, and all-cause mortality in Asian-Americans

2019 ◽  
Vol 30 (8) ◽  
pp. 608-614 ◽  
Author(s):  
Olusola A. Orimoloye ◽  
Sandeep Banga ◽  
Zeina A. Dardari ◽  
S. M. Iftekhar Uddin ◽  
Matthew J. Budoff ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Asian Americans ◽  
Coronary Artery Calcium ◽  
All Cause Mortality

Abstract 031: Diastolic Blood Pressure, Coronary Artery Calcium, and Cardiac Outcomes in the Multi-ethnic Study of Atherosclerosis

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
John W McEvoy ◽  
Faisal Rahman ◽  
Mahmoud Al Rifai ◽  
Michael Blaha ◽  
Khurram Nasir ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Confidence Interval ◽  
Diastolic Blood Pressure ◽  
Coronary Artery Calcium ◽  
J Curve ◽  
Increased Risk ◽  
All Cause Mortality

Diastolic blood pressure (BP) has a J-curve relationship with coronary heart disease and death. Because this association is thought to reflect reduced coronary perfusion at low diastolic BP, our objective was to test whether the J-curve is most pronounced among persons with coronary artery calcium. Among 6,811 participants from the Multi-Ethnic Study of Atherosclerosis, we used Cox models to examine if diastolic BP category is associated with coronary heart disease events, stroke, and mortality. Analyses were conducted in the sample overall and after stratification by coronary artery calcium score. In multivariable-adjusted analyses, compared with diastolic BP of 80 to 89 mmHg (reference), persons with diastolic BP <60 mmHg had increased risk of coronary heart disease events (HR 1.69 [95% confidence interval 1.02-2.79]) and all-cause mortality (HR 1.48 [95% confidence interval 1.10-2.00]), but not stroke. After stratification, associations of diastolic BP <60 mmHg with events were present only among participants with coronary artery calcium >0. Diastolic BP <60 mmHg was not associated with events when coronary artery calcium was zero. We also found no interaction in the association between low diastolic BP and events based on race. In conclusion, diastolic blood pressure <60 mmHg was associated with increased risk of coronary heart disease events and all-cause mortality in the sample overall, but this association appeared strongest among individuals with elevated CAC; suggesting that added caution may be needed when pursuing intensive BP treatment targets among persons with subclinical atherosclerosis.

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