在4个民族或人种人群中冠脉钙化对冠状动脉事件的预测

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Coronary Calcium as a Predictor of Coronary Events in Four Racial or Ethnic Groups
ABSTRACT
摘要：
Background In white populations, computed tomographic measurements of coronary-artery calcium predict coronary heart disease independently of traditional coronary risk factors. However, it is not known whether coronary-artery calcium predicts coronary heart disease in other racial or ethnic groups.
背景：在白人中，CT测量的冠状动脉钙化能独立于传统的冠脉危险因子之外预测冠心病。但是，在别的民族或人种，冠脉钙化是否能预测冠心病目前尚不清楚。
Methods We collected data on risk factors and performed scanning for coronary calcium in a population-based sample of 6722 men and women, of whom 38.6% were white, 27.6% were black, 21.9% were Hispanic, and 11.9% were Chinese. The study subjects had no clinical cardiovascular disease at entry and were followed for a median of 3.8 years.
方法：我们收集了包括6722例男性和女性患者的人群样本的危险因子数据和CT检测的冠脉钙化数据，在这一人群中38.6％为白人，27.6％为黑人，21.9％为西班牙人、11.9％为中国人。这些被研究者没有心血管疾病史，平均随访3.8年。
Results There were 162 coronary events, of which 89 were major events (myocardial infarction or death from coronary heart disease). In comparison with participants with no coronary calcium, the adjusted risk of a coronary event was increased by a factor of 7.73 among participants with coronary calcium scores between 101 and 300 and by a factor of 9.67 among participants with scores above 300 (P<0.001 for both comparisons). Among the four racial and ethnic groups, a doubling of the calcium score increased the risk of a major coronary event by 15 to 35% and the risk of any coronary event by 18 to 39%. The areas under the receiver-operating-characteristic curves for the prediction of both major coronary events and any coronary event were higher when the calcium score was added to the standard risk factors.
结果：一共发生了162例冠状动脉事件，其中89例为主要事件（心肌梗死或者冠心病死亡）。与没有冠脉钙化的被研究者相比，冠脉钙化积分在101-300之间的患者校正后冠状动脉事件危险增加7.73被，冠脉钙化积分在300以上的患者校正后危险增加9.67倍（两项比较P值均小于0.001）。在4个民族或人种中，冠脉钙化积分加倍使得主要冠脉事件危险增加15-35％，任意冠脉事件危险增加18-39％。当冠脉钙化积分添加到标准的危险因子中之后，预测主要冠脉事件和任意冠脉事件的受试者工作特征曲线下面积均增加。
Conclusions The coronary calcium score is a strong predictor of incident coronary heart disease and provides predictive information beyond that provided by standard risk factors in four major racial and ethnic groups in the United States. No major differences among racial and ethnic groups in the predictive value of calcium scores were detected.
结论：在4个民族或种族人群中，冠脉钙化积分是冠心病事件的强预测因子，而且在标准危险因子之外提供预测信息。冠脉钙化积分的预测价值在不同的民族或人种之间没有显著的差异。