Abstract:
BACKGROUND:Computed tomography (CT) allows estimation of coronary artery calcium (CAC) progression. We evaluated several progression algorithms in our unselected, population-based cohort for risk prediction of coronary and cardiovascular events. METHODS:In 3281 participants (45-74 years of age), free from cardiovascular disease until the second visit, risk factors, and CTs at baseline (b) and after a mean of 5.1 years (5y) were measured. Hard coronary and cardiovascular events, and total cardiovascular events including revascularization, as well, were recorded during a follow-up time of 7.8±2.2 years after the second CT. The added predictive value of 10 CAC progression algorithms on top of risk factors including baseline CAC was evaluated by using survival analysis, C-statistics, net reclassification improvement, and integrated discrimination index. A subgroup analysis of risk in CAC categories was performed. RESULTS:We observed 85 (2.6%) hard coronary, 161 (4.9%) hard cardiovascular, and 241 (7.3%) total cardiovascular events. Absolute CAC progression was higher with versus without subsequent coronary events (median, 115 [Q1-Q3, 23-360] versus 8 [0-83], P<0.0001; similar for hard/total cardiovascular events). Some progression algorithms added to the predictive value of baseline CT and risk assessment in terms of C-statistic or integrated discrimination index, especially for total cardiovascular events. However, CAC progression did not improve models including CAC5y and 5-year risk factors. An excellent prognosis was found for 921 participants with double-zero CACb=CAC5y=0 (10-year coronary and hard/total cardiovascular risk: 1.4%, 2.0%, and 2.8%), which was for participants with incident CAC 1.8%, 3.8%, and 6.6%, respectively. When CACb progressed from 1 to 399 to CAC5y≥400, coronary and total cardiovascular risk were nearly 2-fold in comparison with subjects who remained below CAC5y=400. Participants with CACb≥400 had high rates of hard coronary and hard/total cardiovascular events (10-year risk: 12.0%, 13.5%, and 30.9%, respectively). CONCLUSIONS:CAC progression is associated with coronary and cardiovascular event rates, but adds only weakly to risk prediction. What counts is the most recent CAC value and risk factor assessment. Therefore, a repeat scan >5 years after the first scan may be of additional value, except when a double-zero CT scan is present or when the subjects are already at high risk.
journal_name
Circulationjournal_title
Circulationauthors
Lehmann N,Erbel R,Mahabadi AA,Rauwolf M,Möhlenkamp S,Moebus S,Kälsch H,Budde T,Schmermund A,Stang A,Führer-Sakel D,Weimar C,Roggenbuck U,Dragano N,Jöckel KH,Heinz Nixdorf Recall Study Investigators.doi
10.1161/CIRCULATIONAHA.116.027034subject
Has Abstractpub_date
2018-02-13 00:00:00pages
665-679issue
7eissn
0009-7322issn
1524-4539pii
CIRCULATIONAHA.116.027034journal_volume
137pub_type
临床试验,杂志文章,多中心研究相关文献
CIRCULATION文献大全abstract:BACKGROUND:Inflammatory vasculopathies, ranging from the vasculitides (Takayasu arteritis, giant cell arteritis, and polyarteritis nodosa) to atherosclerosis, display remarkable target tissue tropisms for selected vascular beds. Molecular mechanisms directing wall inflammation to restricted anatomic sites within the va...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.108.789172
更新日期:2008-09-16 00:00:00
abstract::The indication for prophylactic temporary and permanent pacing during acute myocardial infarction (MI) complicated by bundle branch block is high risk of progression via a Type II pattern to second or third degree (high degree) AV block during hospitalization or follow-up. In this study, determinants of high degree AV...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.58.4.689
更新日期:1978-10-01 00:00:00
abstract:BACKGROUND:We recently reported that sodium channel block can produce opposite effects on action potential duration (APD) and refractoriness in epicardial versus endocardial tissues of the canine ventricle. In addition, strong sodium channel current inhibition was found to cause loss of the action potential dome in epi...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.87.2.562
更新日期:1993-02-01 00:00:00
abstract:BACKGROUND:Current diagnostic thresholds for ambulatory blood pressure (ABP) mainly rely on statistical parameters derived from reference populations. We determined an outcome-driven reference frame for ABP measurement. METHODS AND RESULTS:We performed 24-hour ABP monitoring in 5682 participants (mean age 59.0 years; ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.106.662254
更新日期:2007-04-24 00:00:00
abstract:BACKGROUND:Clinical and experimental studies have demonstrated a major role of the renin-angiotensin system in the functional and structural changes of the large arteries in hypertension. Because genetic studies may help us to understand the mechanisms underlying the involvement of this system in arterial regulation, t...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.94.4.698
更新日期:1996-08-15 00:00:00
abstract:BACKGROUND:Elevated levels of oxidized phospholipids (OxPLs) on apolipoprotein B-100 particles (OxPL/apoB) are associated with cardiovascular disease and predict new cardiovascular events. Elevated lipoprotein (a) [Lp(a)] levels are a risk factor for cardiovascular disease in whites and also in blacks if they carry sma...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.108.836940
更新日期:2009-04-07 00:00:00
abstract::In 1948 knowledge of the role of the central nervous system in controlling blood pressure was rudimentary and the possibility that the brain could contribute to hypertension was barely acknowledged. Over the past 35 years the development of new technologies, particularly those of the neurosciences, and their applicati...
journal_title:Circulation
pub_type: 历史文章,杂志文章
doi:
更新日期:1984-11-01 00:00:00
abstract:BACKGROUND:Degeneration of xenografts or homografts is a major cause for reoperation in young patients after pulmonary valve replacement. We present the early results of fresh decellularized pulmonary homografts (DPH) implantation compared with glutaraldehyde-fixed bovine jugular vein (BJV) and cryopreserved homografts...
journal_title:Circulation
pub_type: 杂志文章,多中心研究
doi:10.1161/CIRCULATIONAHA.110.012161
更新日期:2011-09-13 00:00:00
abstract::The frequencies of onset of myocardial infarction and sudden cardiac death are increased between 6 AM and 12 noon. Platelet aggregability, which may play a role in the cause of these disorders, has been observed to increase after the normal morning activities of awakening, arising, and ambulating. To determine which m...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.78.1.35
更新日期:1988-07-01 00:00:00
abstract::The dominance of the coronary arterial system was determined angiographically in 75 adult patients with isolated aortic stenosis with or without insufficiency, 25 adult patients with pure aortic insufficiency, 51 adult patients with combined aortic stenosis and mitral valve disease, and 44 children with bicuspid aorti...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.52.2.292
更新日期:1975-08-01 00:00:00
abstract::The significance of the direction of the ST-segment shifts on the 12-lead electrocardiogram was evaluated in 82 consecutive patients with unstable angina. Eighteen patients with ST-segment elevation (group I) were compared with 64 patients with ST-segment depression (group II). There was no difference between group I ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.51.6.1015
更新日期:1975-06-01 00:00:00
abstract:BACKGROUND:Indications for surgical correction of aortic regurgitation have been established mostly in men and have not been validated in women. The outcome of this surgical correction in women is unknown. METHODS AND RESULTS:Baseline characteristics and postoperative outcomes were compared between 51 women and 198 me...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.94.10.2472
更新日期:1996-11-15 00:00:00
abstract:BACKGROUND:Circulatory arrest (CA), which provides a bloodless field and good visualization without the need of aortic cross-clamp, is commonly used to facilitate repair of aortic lesions. However, extended periods of CA may impair cerebral metabolism and cause ischemic injury. Studies were performed to evaluate the ef...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1996-11-01 00:00:00
abstract::Recent molecular studies have suggested that viral myocarditis frequently underlies human congestive cardiomyopathy; however, only moderately sensitive and specific techniques were used. Polymerase chain reaction (PCR) gene amplification is a sensitive, specific technique ideally suited for the diagnosis of viral dise...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.82.1.8
更新日期:1990-07-01 00:00:00
abstract::Coronary artery bypass surgery with or without aneurysmectomy has been used to treat patients with angiographically defined left ventricular aneurysm. To evaluate whether surgery benefits such patients, we analyzed the data from 1131 patients who were enrolled in the registry of the Coronary Artery Surgery Study. Four...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.74.1.110
更新日期:1986-07-01 00:00:00
abstract:BACKGROUND:Macrophage migration inhibitory factor (MIF), a cytokine that controls cell-mediated inflammatory responses, is upregulated in atherogenesis; however, its functional contribution to lesion development has not been evaluated. METHODS AND RESULTS:We studied the role of MIF on neointima lesion formation after ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000109201.72441.09
更新日期:2004-01-27 00:00:00
abstract::Echocardiography and Doppler ultrasound are useful in evaluating a variety of pathological conditions affecting the pericardium. Cardiac tamponade results in right atrial collapse and right ventricular diastolic collapse detectable by echocardiography. These echocardiographic signs have a high degree of sensitivity an...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:Previous studies in animal models of angioplasty have suggested a role in neointimal hyperplasia for endothelins (ETs), potent vasoconstricting peptides that also exert growth-promoting effects. The present studies were undertaken to test the hypothesis that endothelin receptor blockade can reduce neointimal...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.103.14.1899
更新日期:2001-04-10 00:00:00
abstract:BACKGROUND:Previous evidence has shown that increased sympathetic tone enhances the cesium chloride (Cs)-induced early afterdepolarizations (EADs) and ventricular tachycardias (VTs). METHODS AND RESULTS:We assessed the effects of vagal stimulation on Cs-induced EADs and ventricular arrhythmias in the rabbit heart. Mon...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.86.6.1987
更新日期:1992-12-01 00:00:00
abstract::In previous studies from this laboratory, we found that approximately 30% of women with chest pain and normal coronary arteries demonstrated either a decrease in or a failure to increase radionuclide ejection fraction during exercise. To examine the hypothesis that this apparent abnormality in left ventricular functio...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.70.3.357
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND:Receptor-mediated activation of myocardial Gq signaling is postulated as a biochemical mechanism transducing pressure-overload hypertrophy. The specific effects of Gq activation on the functional and morphological adaptations to pressure overload are not known. METHODS AND RESULTS:To determine the effects o...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.97.15.1488
更新日期:1998-04-21 00:00:00
abstract:BACKGROUND:The role of endothelial nitric oxide synthase (eNOS) in ischemic preconditioning (PC) and cardioprotection is poorly understood. We addressed this issue using a genetic, rather than pharmacological, approach. METHODS AND RESULTS:In the nonpreconditioned state, eNOS-/- mice exhibited infarct sizes similar to...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.107.689471
更新日期:2007-07-31 00:00:00
abstract::The continuity equation suggests that a ratio of velocities at two different cardiac valves is inversely proportional to the ratio of cross-sectional areas of the valves. To determine whether a ratio of mitral/aortic valve orifice velocities is useful in determining aortic valve area in patients with aortic stenosis, ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.73.5.964
更新日期:1986-05-01 00:00:00
abstract:BACKGROUND:Transcatheter aortic valve replacement (TAVR) represents a paradigm shift in the therapeutic options for patients with severe aortic stenosis. However, rapid and exponential growth in TAVR demand may overwhelm capacity, translating to inadequate access and prolonged wait times. Our objective was to evaluate ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.117.033432
更新日期:2018-07-31 00:00:00
abstract:BACKGROUND:Pulmonary veno-occlusive disease is caused by excessive cell proliferation and fibrosis, which obliterate the lumen of pulmonary venules, leading to pulmonary hypertension, right ventricular failure, and death. This condition has no effective treatment and a 5-year survival of <5%. Understanding the mechanis...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.113.007822
更新日期:2014-09-30 00:00:00
abstract::The existence of a brain renin-angiotensin system (RAS) as one of various tissue RASs is now firmly established. Angiotensin-containing pathways within brain areas involved in central blood pressure regulation have been described. Evidence from biochemical, neurophysiologic, pharmacologic, and most recently, molecular...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:
更新日期:1988-06-01 00:00:00
abstract::Paclitaxel drug-coated balloons and drug-eluting stents became commercially available for the treatment of intermittent claudication in 2015 and 2012, respectively. Both devices demonstrated superiority in limb revascularization compared with non-paclitaxel-coated devices and were rapidly accepted into clinical practi...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.119.041099
更新日期:2019-10-15 00:00:00
abstract:BACKGROUND:After cardiopulmonary bypass (CPB), pulmonary hypertension and its associated increased vascular reactivity are a major source of morbidity, particularly for children with increased pulmonary blood flow. Although post-CPB pulmonary hypertension is well described, its mechanisms remain incompletely understood...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.95.4.1054
更新日期:1997-02-18 00:00:00
abstract:BACKGROUND:Vascular endothelial growth factor (VEGF) is an endothelial cell-specific mitogen that is angiogenic in vitro and in vivo. It has been hypothesized that VEGF plays a role in myocardial collateral formation; however, the effects of VEGF on collateral flow to ischemic myocardium are unknown. METHODS AND RESUL...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.89.5.2183
更新日期:1994-05-01 00:00:00
abstract:BACKGROUND:Conflicting results from recent observational studies have raised questions concerning the benefit of β-blockers for patients undergoing coronary artery bypass grafting (CABG). Furthermore, the efficacy of long-term β-blocker therapy in CABG patients after hospital discharge is uncertain. METHODS AND RESULT...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.114.014209
更新日期:2015-06-23 00:00:00