Circulation. Cardiovascular imaging · 2026
Race and Ethnic-Specific Burden of Aortic Valve Calcium and Its Association With Long-Term Aortic Stenosis: Multi-Ethnic Study of Atherosclerosis.
СтатьяМногоцентровое исследованиеСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Grant Jelani K, Jha Kunal, Marrero Natalie, Razavi Alexander C, Boakye Ellen, Anchouche Khalil, Dzaye Omar, Budoff Matthew J, Shah Sanjiv J, Czarny Matthew J, Rotter Jerome I, Guo Xiuqing, Yao Jie, Thanassoulis George, Post Wendy S, Blaha Michael J, Whelton Seamus P
Аннотация
BACKGROUND: Racial and ethnic differences have been reported for aortic valve calcium (AVC) and long-term aortic stenosis (AS). Whether these differences are due to differing risk factor profiles or the burden of AVC is unknown.
METHODS: Baseline AVC was quantified using the Agatston method among 6812 MESA (Multi-Ethnic Study of Atherosclerosis) participants. AVC scores were not reported to participants. The primary outcome of long-term moderate or severe AS was adjudicated using standard clinical criteria. We calculated multivariable Cox proportional hazards with log-transformed AVC as a continuous variable for each race and ethnicity.
RESULTS: The mean age was 62 years, and 47% of participants were women. Over a median follow-up of 16.7 years, 140 participants were diagnosed with moderate (n=56) and severe AS (n=84). The prevalence of baseline AVC >0 by self-reported race and ethnicity was White (15.8%), Hispanic (13.3%), Black (12.3%), and Chinese (8.3%). The rate of long-term incident moderate-severe AS was highest for White participants (2.1/1000 person-years) and lowest for Chinese participants (0.5/1000 person-years). The association of AVC with moderate-severe AS was significant for all race and ethnicity groups: White hazard ratio, 1.82 (95% CI, 1.62-2.03); Hispanic hazard ratio, 2.18 (95% CI, 1.82-2.62); Black hazard ratio, 2.28 (95% CI, 1.78-2.93); and Chinese hazard ratio, 3.65 (95% CI, 1.05-12.71) per 1 unit higher log transformed AVC. There was no interaction by race and ethnicity (P=0.26) when modeling Black versus non-Black participants.
CONCLUSIONS: The racial and ethnic groups with a higher baseline prevalence of AVC had a higher long-term incidence of moderate-severe AS, but a similar relative association between AVC and moderate-severe AS regardless of baseline atherosclerotic cardiovascular disease risk. Our findings suggest that differences in AS by race and ethnicity may likely be explained by the burden of AVC.
METHODS: Baseline AVC was quantified using the Agatston method among 6812 MESA (Multi-Ethnic Study of Atherosclerosis) participants. AVC scores were not reported to participants. The primary outcome of long-term moderate or severe AS was adjudicated using standard clinical criteria. We calculated multivariable Cox proportional hazards with log-transformed AVC as a continuous variable for each race and ethnicity.
RESULTS: The mean age was 62 years, and 47% of participants were women. Over a median follow-up of 16.7 years, 140 participants were diagnosed with moderate (n=56) and severe AS (n=84). The prevalence of baseline AVC >0 by self-reported race and ethnicity was White (15.8%), Hispanic (13.3%), Black (12.3%), and Chinese (8.3%). The rate of long-term incident moderate-severe AS was highest for White participants (2.1/1000 person-years) and lowest for Chinese participants (0.5/1000 person-years). The association of AVC with moderate-severe AS was significant for all race and ethnicity groups: White hazard ratio, 1.82 (95% CI, 1.62-2.03); Hispanic hazard ratio, 2.18 (95% CI, 1.82-2.62); Black hazard ratio, 2.28 (95% CI, 1.78-2.93); and Chinese hazard ratio, 3.65 (95% CI, 1.05-12.71) per 1 unit higher log transformed AVC. There was no interaction by race and ethnicity (P=0.26) when modeling Black versus non-Black participants.
CONCLUSIONS: The racial and ethnic groups with a higher baseline prevalence of AVC had a higher long-term incidence of moderate-severe AS, but a similar relative association between AVC and moderate-severe AS regardless of baseline atherosclerotic cardiovascular disease risk. Our findings suggest that differences in AS by race and ethnicity may likely be explained by the burden of AVC.
Предметные рубрики MeSH
AgedAged, 80 and overFemaleHumansMaleMiddle AgedAortic ValveAortic Valve StenosisAsianAtherosclerosisBlack or African AmericanCalcinosisEthnicityHispanic or LatinoIncidenceMultivariate AnalysisPrevalenceProportional Hazards ModelsProspective StudiesRisk AssessmentRisk FactorsSeverity of Illness IndexTime FactorsUnited StatesWhite