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Erbel, R.* ; Lehmann, N.* ; Churzidse, S.* ; Rauwolf, M.* ; Mahabadi, A.A.* ; Möhlenkamp, S.* ; Moebus, S.* ; Bauer, M.* ; Kälsch, H.* ; Budde, T.* ; Montag, M.* ; Schmermund, A.* ; Stang, A.* ; Führer-Sakel, D.* ; Weimar, C.* ; Roggenbuck, U.* ; Dragano, N.* ; Jöckel, K.-H.* ; Heinz Nixdorf Recall Study Investigative Group (Löwel, H.*)

Progression of coronary artery calcification seems to be inevitable, but predictable - results of the Heinz Nixdorf Recall (HNR) study.

Eur. Heart J. 35, 2960-2971 (2014)
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AIM: Coronary artery calcification (CAC), as a sign of atherosclerosis, can be detected and progression quantified using computed tomography (CT). We develop a tool for predicting CAC progression. METHODS AND RESULTS: In 3481 participants (45-74 years, 53.1% women) CAC percentiles at baseline (CACb) and after five years (CAC₅y) were evaluated, demonstrating progression along gender-specific percentiles, which showed exponentially shaped age-dependence. Using quantile regression on the log-scale (log(CACb+1)) we developed a tool to individually predict CAC₅y, and compared to observed CAC₅y. The difference between observed and predicted CAC₅y (log-scale, mean±SD) was 0.08±1.11 and 0.06±1.29 in men and women. Agreement reached a kappa-value of 0.746 (95% confidence interval: 0.732-0.760) and concordance correlation (log-scale) of 0.886 (0.879-0.893). Explained variance of observed by predicted log(CAC₅y+1) was 80.1% and 72.0% in men and women, and 81.0 and 73.6% including baseline risk factors. Evaluating the tool in 1940 individuals with CACb>0 and CACb<400 at baseline, of whom 242 (12.5%) developed CAC₅y>400, yielded a sensitivity of 59.5%, specificity 96.1%, (+) and (-) predictive values of 68.3% and 94.3%. A pre-defined acceptance range around predicted CAC₅y contained 68.1% of observed CAC₅y; only 20% were expected by chance. Age, blood pressure, lipid-lowering medication, diabetes, and smoking contributed to progression above the acceptance range in men and, excepting age, in women. CONCLUSION: CAC nearly inevitably progresses with limited influence of cardiovascular risk factors. This allowed the development of a mathematical tool for prediction of individual CAC progression, enabling anticipation of the age when CAC thresholds of high risk are reached.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Schlagwörter Ct ; Coronary Artery Calcification ; Epidemiology ; Heinz Nixdorf Recall Study ; Imaging ; Progression Of Atherosclerosis
ISSN (print) / ISBN 0195-668X
e-ISSN 1522-9645
Quellenangaben Band: 35, Heft: 42, Seiten: 2960-2971 Artikelnummer: , Supplement: ,
Verlag Oxford University Press
Begutachtungsstatus Peer reviewed