Coronary Artery Calcium as a Synergistic Tool for the Age- and Sex-Specific Risk of Cardiovascular and Cancer Mortality: The Coronary Artery Calcium Consortium
Autor: | Dzaye, Omar, Al Rifai, Mahmoud, Dardari, Zeina, Shaw, Leslee J, Al-Mallah, Mouaz H, Handy Marshall, Catherine, Rozanski, Alan, Mortensen, Martin B, Duebgen, Matthias, Matsushita, Kunihiro, Rumberger, John A, Berman, Daniel S, Budoff, Matthew J, Miedema, Michael D, Nasir, Khurram, Blaha, Michael J, Whelton, Seamus P |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male sex differences Aging Time Factors Coronary Artery Disease Cardiorespiratory Medicine and Haematology Coronary Angiography competing risk Cardiovascular Severity of Illness Index Risk Assessment Sex Factors Risk Factors Predictive Value of Tests cardiovascular disease Neoplasms Cause of Death Humans cardiovascular diseases Aetiology Vascular Calcification coronary artery calcium Heart Disease - Coronary Heart Disease Aged Prevention Age Factors nutritional and metabolic diseases Middle Aged Prognosis United States Heart Disease Good Health and Well Being Cardiovascular Diseases Female 2.4 Surveillance and distribution |
Zdroj: | Journal of the American Heart Association, vol 9, iss 8 |
Popis: | Background Coronary artery calcium (CAC) is a predictor for the development of cardiovascular disease (CVD) and to a lesser extent cancer. The age- and sex-specific relationship of CAC with CVD and cancer mortality is unknown. Methods and Results Asymptomatic patients aged 40 to 75years old without known CVD were included from the CAC Consortium. We calculated sex-specific mortality rates per 1000person-years' follow-up. Using parametric survival regression modeling, we determined the age- and sex-specific CAC score at which the risk of death from CVD and cancer were equal. Among the 59502 patients included in this analysis, the mean age was 54.9 (±8.5) years, 34% were women, and 89% were white. There were 671 deaths attributable to CVD and 954 deaths attributable to cancer over a mean follow-up of 12±3years. Among patients with CAC=0, cancer was the leading cause of death, the total mortality rate was low (women, 1.8; men, 1.5), and the CVD mortality rate was exceedingly low for women (0.3) and men (0.3). The age-specific CAC score at which the risk of CVD and cancer mortality were equal had a U-shaped relationship for women, while the relationship was exponential for men. Conclusions The age- and sex-specific relationship of CAC with CVD and cancer mortality differed significantly for women and men. Our age- and sex-specific CAC score provides a more precise estimate and further facilitates the use of CAC as a synergistic tool in strategies for the prediction and prevention of CVD and cancer mortality. |
Databáze: | OpenAIRE |
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