CT-Detected Growth of Coronary Artery Calcification in Asymptomatic Middle-Aged Subjects and Association With 15 Biomarkers

This study sought to determine the incidence and progression of coronary artery calcification (CAC) in asymptomatic middle-aged subjects and to evaluate the value of a broad panel of biomarkers in the prediction of CAC growth. CAC continues to be a major risk factor, but the value of biochemical mar...

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Bibliographic Details
Published in:JACC. Cardiovascular imaging Vol. 10; no. 8; p. 858
Main Authors: Diederichsen, Søren Zöga, Grønhøj, Mette Hjortdal, Mickley, Hans, Gerke, Oke, Steffensen, Flemming Hald, Lambrechtsen, Jess, Rønnow Sand, Niels Peter, Rasmussen, Lars Melholt, Olsen, Michael Hecht, Diederichsen, Axel
Format: Journal Article
Language:English
Published: United States 01.08.2017
Subjects:
Asymptomatic Diseases
Biomarkers - blood
Bone Remodeling
Chi-Square Distribution
Computed Tomography Angiography
Coronary Angiography - methods
Coronary Artery Disease - blood
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - epidemiology
Denmark - epidemiology
Disease Progression
Female
Humans
Incidence
Inflammation Mediators - blood
Kidney - metabolism
Kidney - physiopathology
Linear Models
Lipids - blood
Logistic Models
Male
Middle Aged
Multivariate Analysis
Myocardium - metabolism
Myocardium - pathology
Necrosis
Odds Ratio
Phosphates - blood
Predictive Value of Tests
Prevalence
Prospective Studies
Risk Factors
Time Factors
Vascular Calcification - blood
Vascular Calcification - diagnostic imaging
Vascular Calcification - epidemiology
coronary artery calcification
X-ray computed tomography
imaging
biomarkers
ISSN:1876-7591, 1876-7591
Online Access:Get more information
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Summary:This study sought to determine the incidence and progression of coronary artery calcification (CAC) in asymptomatic middle-aged subjects and to evaluate the value of a broad panel of biomarkers in the prediction of CAC growth. CAC continues to be a major risk factor, but the value of biochemical markers in predicting CAC incidence and progression remains unresolved. At baseline, 1,227 men and women underwent traditional risk assessment and a computed tomography (CT) scan to determine the CAC score. Biomarkers of calcium-phosphate metabolism (calcium, phosphate, vitamin D , parathyroid hormone, osteoprotegerin), lipid metabolism (triglyceride, high- and low-density lipoprotein, total cholesterol), inflammation (C-reactive protein, soluble urokinase-type plasminogen activator receptor), kidney function (creatinine, cystatin C, urate), and myocardial necrosis (cardiac troponin I) were analyzed. A second CT scan was scheduled after 5 years. General linear models were performed to examine the association between biomarkers and ΔCAC score, and additionally, sensitivity analyses were performed in terms of binary and ordinal logistic regressions. A total of 1,006 participants underwent a CT scan after 5 years. Among the 562 participants with a baseline CAC score of 0, 189 (34%) had incident CAC, whereas 214 (48%) of the 444 participants with baseline CAC score >0 had significant progression (>15% annual increase in CAC score). In the multivariate models (n = 1,006), age, sex, hypertension, diabetes, dyslipidemia, and smoking were associated with ΔCAC, whereas the strongest predictor was baseline CAC score. Low-density lipoprotein and total cholesterol levels were independently associated with CAC incidence (n = 562; incidence rate ratio [IRR]: 1.47; 95% confidence interval [CI]: 1.05 to 2.05; and IRR: 1.34; 95% CI: 1.01 to 1.77, respectively), whereas phosphate level was associated with CAC progression (n = 444; IRR: 3.60; 95% CI: 1.42 to 9.11). In this prospective study, a large part of participants had incident CAC or progression of prevalent CAC at 5 years of follow-up. Low-density lipoprotein and total cholesterol were associated with CAC incidence and phosphate with CAC progression, whereas 12 other biomarkers had little value.
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ISSN:1876-7591
1876-7591
DOI:10.1016/j.jcmg.2017.05.010