Associations of Long-Term and Early Adult Atherosclerosis Risk Factors With Aortic and Mitral Valve Calcium

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:55

Article

Thanassoulis, George^4,6,9  Massaro, Joseph M.^10,12  Cury, Ricardo^2,3  Manders, Emily⁶  Benjamin, Emelia J.^6,11,13,14  Vasan, Ramachandran S.^6,14  Cupple, L. Adrienne^6,10,11  Hoffmann, Udo^2,3  O'Donnell, Christopher J.^4,6,15  Kathiresan, Sekar^1,4,5,6,7,8 

[1] Harvard Univ, Sch Med, Massachusetts Gen Hosp, Ctr Human Genet Res, Boston, MA 02114 USA

[2] Harvard Univ, Sch Med, Massachusetts Gen Hosp, Div Radiol, Boston, MA 02114 USA

[3] Harvard Univ, Sch Med, Massachusetts Gen Hosp, Cardiac MR PET CT Program, Boston, MA 02114 USA

[4] Harvard Univ, Sch Med, Massachusetts Gen Hosp, Div Cardiol, Boston, MA 02114 USA

[5] Harvard Univ, Sch Med, Massachusetts Gen Hosp, Cardiovasc Res Ctr, Boston, MA 02114 USA

[6] NHLBI, Framingham Heart Study, Framingham, MA USA

[7] Harvard Univ, Cambridge, MA 02138 USA

[8] MIT, Program Med & Populat Genet, Broad Inst, Cambridge, MA 02139 USA

[9] Boston Univ, Sch Med, Boston, MA 02118 USA

[10] Boston Univ, Dept Biostat, Boston, MA 02118 USA

[11] Boston Univ, Dept Epidemiol, Boston, MA 02118 USA

[12] Boston Univ, Dept Math & Stat, Boston, MA 02118 USA

[13] Boston Univ, Evans Dept Med, Boston, MA 02118 USA

[14] Boston Univ, Whitaker Cardiovasc Inst, Boston, MA 02118 USA

[15] NHLBI, Div Intramural Res, Bethesda, MD 20892 USA

关键词: aortic valve;    atherosclerosis;    calcification;    mitral valve;    stenosis;   

DOI  :  10.1016/j.jacc.2010.03.019

来源: Elsevier

【 摘 要 】

Objectives To determine the association of long-term exposure to atherosclerosis risk factors with valvular calcification. Background Traditional atherosclerosis risk factors have been associated with aortic and mitral valve calcium in cross-sectional studies, but long-term prospective data are lacking. Methods This was a prospective, community-based cohort study with 27-year follow-up (median follow-up 26.9 years; range 23.1 to 29.6 years). Participants from the Framingham Offspring Study (n = 1,323, enrolled between 1971 and 1975, mean age at enrollment 34 +/- 9 years; 52% women) underwent cardiac multidetector computed tomography assessment between 2002 and 2005. Associations between the long-term average of each cardiovascular risk factor and valve calcium were estimated using logistic regression. Results Aortic valve calcium was present in 39% of participants and mitral valve calcium in 20%. In multivariable models, the odds ratio for aortic valve calcium associated with every SD increment in long-term mean total cholesterol was 1.74 (p < 0.0001); with every SD increment in high-density lipoprotein cholesterol, it was 0.77 (p = 0.002); and with every 9 cigarettes smoked per day, it was 1.23 (p = 0.002). Associations of similar magnitude were seen for mitral valve calcium. The mean of 3 serum C-reactive protein measurements was associated with mitral valve calcium (odds ratio: 1.29 per SD increment in C-reactive protein levels; p = 0.002). A higher Framingham risk score in early adulthood (40 years age or younger) was associated with increased prevalence and severity of aortic valve calcium measured 3 decades later. Conclusions Exposure to multiple atherosclerotic risk factors starting in early to mid-adulthood is associated with aortic and mitral valve calcium. Studies evaluating early risk factor modification to reduce the burden of valve disease are warranted. (J Am Coll Cardiol 2010; 55: 2491-8) (C) 2010 by the American College of Cardiology Foundation

【 授权许可】

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