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Research ArticleOriginal Research

Coronary Artery Calcium Progression Is Associated with Cardiovascular Events Among Asymptomatic Individuals: From the North Texas Primary Care Practice-based Research Network (NorTex-PBRN)

Roberto Cardarelli, Alexandria Hall and Wade Rankin
The Journal of the American Board of Family Medicine September 2017, 30 (5) 592-600; DOI: https://doi.org/10.3122/jabfm.2017.05.170032
Roberto Cardarelli
the Department of Family & Community Medicine (RC, WR), University of Kentucky College of Medicine (AH), Lexington.
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Alexandria Hall
the Department of Family & Community Medicine (RC, WR), University of Kentucky College of Medicine (AH), Lexington.
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Wade Rankin
the Department of Family & Community Medicine (RC, WR), University of Kentucky College of Medicine (AH), Lexington.
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  • Article
  • Figures & Data
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Article Figures & Data

Tables

    • View popup
    Table 1.

    Population Demographics by Coronary Artery Calcification Change over 2 Years (N = 311)

    Increase in CACNo Change or Improvement in CAC
    Time between CAC measures, months, mean (SD)25.56 (2.60)25.31 (2.36)
    Change in CAC, mean (SD)82.41 (206.78)−5.59 (62.44)
    Age, mean (SD)58.40 (8.57)53.95 (7.33)
    Sex
        Female60 (53.1)152 (69.7)
        Male53 (46.9)66 (30.3)
    Race/ethnicity
        White45 (39.8)60 (27.5)
        Hispanic/Latino33 (29.2)74 (33.9)
        African American35 (31.0)84 (38.5)
    Disease status at baseline
        Hypertension66 (76.7)94 (61.0)
        Dyslipidemia75 (69.4)99 (46.3)
        Diabetes mellitus25 (23.8)27 (12.9)
    Chronic diseases (n)
        09 (11.0)41 (27.3)
        123 (28.0)48 (32.0)
        234 (41.5)50 (33.3)
        316 (19.5)11 (7.3)
    Disease measures at baseline, mean (SD)
        Low-density lipoprotein115.66 (43.82)111.10 (32.42)
        HDL52.24 (13.56)55.62 (16.49)
        Triglycerides165.52 (151.18)135.97 (77.08)
        Non-HDL147.12 (50.10)138.28 (36.39)
        Systolic blood pressure134.95 (16.12)127.59 (13.91)
        Diastolic blood pressure81.67 (9.02)79.74 (8.34)
        Fasting glucose107.48 (37.20)97.51 (16.92)
    Body mass index, mean (SD)31.21 (6.59)30.42 (6.06)
    • Data are n (%) unless otherwise indicated. Values may not add up to 311 because of missing data.

    • CAC, coronary artery calcification; HDL, high-density lipoprotein; SD, standard deviation.

    • View popup
    Table 2.

    Composite Cardiovascular Disease Event and Coronary Artery Calcification Change over 2 Years (N = 311)

    CAC ProgressionCVD
    Composite Event*No Event
    Increase16 (69.6)89 (31.8)
    No change/improvement7 (30.4)191 (68.2)
    P < .001
    • Data are n (%). Values may not add up to 311 because of missing data.

    • ↵* Experienced a myocardial infarction, stroke, transient ischemic attack, heart failure, peripheral arterial disease, or other heart condition within the previous 2 years.

    • CAC, coronary artery calcification; CVD, cardiovascular disease.

    • View popup
    Table 3.

    Cardiovascular Factors and Increase in Coronary Artery Calcium Scores over 2 Years

    Change in CAC
    Unadjusted ModelAdjusted Model*
    OR95% CIP ValueOR95% CIP Value
    Age1.071.04–1.10<.001———
    Sex
        Female——————
        Male2.031.27–3.25.003———
    Disease status at baseline
        Hypertension2.111.16–3.83.011.680.89–3.16.11
        Dyslipidemia2.641.62–4.31<.0012.191.32–3.66.003
        Diabetes mellitus2.111.15–3.85.021.911.01–3.63.05
    Chronic diseases (n)
        0——————
        12.180.91–5.24.081.710.69–4.24.25
        23.101.33–7.20.012.471.02–5.98.04
        36.632.31–19.00<.0014.801.57–14.73.01
    Disease measures at baseline
        Low-density lipoprotein1.001.00–1.01.291.011.00–1.01.10
        HDL0.990.97–1.00.060.990.97–1.01.18
        Triglycerides1.001.00–1.01.041.001.00–1.01.08
        Non-HDL1.011.00–1.01.071.011.00–1.01.04
        Systolic blood pressure1.031.01–1.06.0021.031.01–1.06.01
        Diastolic blood pressure1.030.99–1.07.151.041.00–1.08.07
        Fasting glucose1.021.01–1.03.0031.011.00–1.02.01
    Body mass index1.020.96–1.07.571.020.98–1.06.28
    • ↵* Adjusted for age and sex.

    • CAC, coronary artery calcification; CI, confidence interval; HDL, high-density lipoprotein; OR, odds ratio.

    • View popup
    Table 4.

    Coronary Artery Calcium Progression and Development of a Cardiovascular Disease Event over 2 Years

    CAC ProgressionComposite CVD Event
    Unadjusted Model*Adjusted Model†
    OR95% CIP ValueOR95% CIP Value
    No change/improvement——————
    Increase4.911.95–12.35.0014.061.47–11.21.007
    • ↵* Experienced a myocardial infarction, stroke, transient ischemic attack, heart failure, peripheral arterial disease, or other heart condition within the previous 2 years.

    • ↵† Adjusted for age, sex, hypertension, dyslipidemia, diabetes mellitus, number of chronic conditions, and body mass index.

    • CAC, coronary artery calcification; CI, confidence interval; CVD, cardiovascular disease; OR, odds ratio.

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The Journal of the American Board of Family     Medicine: 30 (5)
The Journal of the American Board of Family Medicine
Vol. 30, Issue 5
September-October 2017
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Coronary Artery Calcium Progression Is Associated with Cardiovascular Events Among Asymptomatic Individuals: From the North Texas Primary Care Practice-based Research Network (NorTex-PBRN)
Roberto Cardarelli, Alexandria Hall, Wade Rankin
The Journal of the American Board of Family Medicine Sep 2017, 30 (5) 592-600; DOI: 10.3122/jabfm.2017.05.170032

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Coronary Artery Calcium Progression Is Associated with Cardiovascular Events Among Asymptomatic Individuals: From the North Texas Primary Care Practice-based Research Network (NorTex-PBRN)
Roberto Cardarelli, Alexandria Hall, Wade Rankin
The Journal of the American Board of Family Medicine Sep 2017, 30 (5) 592-600; DOI: 10.3122/jabfm.2017.05.170032
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Keywords

  • Atherosclerotic Plaque
  • Blood Pressure
  • Cardiovascular Diseases
  • Dyslipidemia
  • Practice-Based Research
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