理想心血管健康指标与冠状动脉钙化的横断面研究

Cross sectional study of ideal cardiovascular health metrics and coronary artery calcification

目的以唐山市人群为基础,研究理想心血管健康指标(ideal cardiovascular health metrics,ICHM)与冠状动脉钙化(coronary artery calcification,CAC)的关系。方法利用2999名2013～2014年唐山弘慈医院40岁以上体检人群资料,采用横断面研究方法分析ICHM与CAC之间的关系。ICHM是根据美国心脏协会的定义确定的。根据ICHM度量得分的四分位数,将研究对象分为4类:Ⅰ(0-2),Ⅱ(3),Ⅲ(4)和Ⅳ(5-7)。通过使用双源CT评估研究对象CAC情况,根据常规做法,分别按照0,10,100和400 Agatston单位的临界值确定患者。结果使用CAC得分临界值确定的亚临床动脉粥样硬化患病率分别为15.92%、13.85%、6.76%、1.93%。以CAC得分0作为临界值,以ICHM第Ⅰ组为参照,在调整年龄,性别,收入水平,教育水平和酒精使用情况后,OR值分别为0.86(95%CI,0.63-1.17;P<0.05),0.75(95%CI,0.55-1.02;P<0.05),0.49(95%CI,0.35-0.69;P<0.05)。当使用不同的CAC得分临界值(0,10,100和400)时,CAC与ICHM指标的关系是一致的。结论具有更多ICHM的研究对象的亚临床动脉粥样硬化患病率较低。ICHM作为CAC的保护因素,分组等级越高与CAC关联强度越强。

Objective To investigate the association between ideal cardiovascular health metrics（ICHM） and coronary artery calcifieation（CAC）.Methods A cross-sectional study consisting of 2999 participants aged ≥40 years from the Jidong community of Tangshan City was conducted between 2013 and 2014 to examine the association between the ideal cardiovascular health metrics（ICHM） and CAC.The ideal ICHM metrics were determined based on the definition of the American Heart Association（AHA）.The participants were then grouped into 4 categories according to the quartiles of their ICHM scores as follows：first quartile（0-2）,second quartile（3）,third quartile（4）,and fourth quartile（5-7）.CAC was assessed by using high-pitch dual-source CT,and patients were identified based on thresholds of 0,10,100,or 400 Agatston units,as common practice.Results The prevalence of subclinical atherosclerosis was 15.92%,13.85%,6.76%,and 1.93%,determined by using the CAC scores at thresholds of 0,10,100,and 400 Agatston units,respectively.Compared with the group in the first quartile,the zero of CAC score as the critical value,after adjusting for age,sex,income level,education level,and alcohol use in the logistic regression analysis.The odds ratios in these groups were 0.86 [95% CI：0.63-1.17,P〈0.05）],0.75（95% CI,0.55-1.02,P〈0.05）,and 0.49（95% CI：0.35-0.69,P〈0.05）,respectively.These associations of CAC with the ICHM metrics were consistent when different CAC cutoff scores were used（0,10,100,or 400）.Conclusions The participants with more-ideal cardiovascular metrics had a lower prevalence of subclinical atherosclerosis determined according to CAC score.ICHM as a protective factor for CAC,the higher the grouping level,the stronger the association strength with CAC.