Signs of subclinical coronary atherosclerosis in relation to risk factor distribution in the Multi-Ethnic Study of Atherosclerosis (MESA) and the Heinz Nixdorf Recall Study (HNR).
OBJECTIVE
Modern imaging technology allows us the visualization of coronary artery calcification (CAC), a marker of subclinical coronary atherosclerosis. The prevalence, quantity, and risk factors for CAC were compared between two studies with similar imaging protocols but different source populations: the Multi-Ethnic Study of Atherosclerosis (MESA) and the Heinz Nixdorf Recall Study (HNR).


RESULTS
The measured CAC in 2220 MESA participants were compared with those in 3,126 HNR participants with the inclusion criteria such as age 45-75 years, Caucasian race, and free of baseline cardiovascular disease. Despite similar mean levels of CAC of 244.6 among participants in MESA and of 240.3 in HNR (P = 0.91), the prevalence of CAC > 0 was lower in MESA (52.6%) compared with HNR (67.0%) with a prevalence rate ratio of CAC > 0 of 0.78 [95% confidence interval (CI): 0.72-0.85] after adjustment for known risk factors. Consequently, among participants with CAC > 0, the participants in MESA tended to have higher levels of CAC than those in HNR (ratio of CAC levels: 1.39; 95% CI: 1.19-1.63), since many HNR participants have small (near zero) CAC values.


CONCLUSIONS
The CAC prevalence was lower in the United States (MESA) cohort than in the German (HNR) cohort, which may be explained by more favourable risk factor levels among the MESA participants. The predictors for increased levels of CAC were, however, similar in both cohorts with the exception that male gender, blood pressure, and body mass index were more strongly associated in the HNR cohort.
Erbel
Raimund
R
Department of Cardiology, University of Duisburg-Essen, Essen, Germany. erbel@uk-essen.de
Delaney
Joseph A C
JA
Lehmann
Nils
N
McClelland
Robyn L
RL
Möhlenkamp
Stefan
S
Kronmal
Richard A
RA
Schmermund
Axel
A
Moebus
Susanne
S
Dragano
Nico
N
Stang
Andreas
A
Jöckel
Karl-Heinz
KH
Budoff
Matthew J
MJ
D000367:Age Factors; D000368:Aged; D002114:Calcinosis / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D005858:Germany / Q000453:epidemiology / Q000208:ethnology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014481:United States / Q000453:epidemiology / Q000208:ethnology