Coronary Calcium as a Predictor of Coronary Events in Four Racial or Ethnic Groups

作者：Robert Detrano, Alan D. Guerci, J. Jeffrey Carr, Diane E. Bild, Gregory L. Burke, Aaron R. Folsom, Kiang Liu, Steven Shea, Moysés Szklo, David A. Bluemke, Daniel H. O’Leary, Russell P. Tracy, Karol E. Watson, Nathan D. Wong, Richard A. Kronmal · 发表于：New England Journal of Medicine · 年份：2008 · DOI：10.1056/nejmoa072100 · 被引用次数：3005 · 研究领域：Cardiac Imaging and Diagnostics、Parathyroid Disorders and Treatments、Bone health and osteoporosis research

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. 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. 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. CONCLUSIONS: The coronary calcium score is ...