TY - JOUR
T1 - Subclinical vascular composites predict clinical cardiovascular disease, stroke, and dementia
T2 - The Multi-Ethnic Study of Atherosclerosis (MESA)
AU - Hughes, Timothy M.
AU - Tanley, Jordan
AU - Chen, Haiying
AU - Schaich, Christopher L.
AU - Yeboah, Joseph
AU - Espeland, Mark A.
AU - Lima, Joao A.C.
AU - Ambale-Venkatesh, Bharath
AU - Michos, Erin D.
AU - Ding, Jingzhong
AU - Hayden, Kathleen
AU - Casanova, Ramon
AU - Craft, Suzanne
AU - Rapp, Stephen R.
AU - Luchsinger, José A.
AU - Fitzpatrick, Annette L.
AU - Heckbert, Susan R.
AU - Post, Wendy S.
AU - Burke, Gregory L.
N1 - Publisher Copyright:
© 2024 Elsevier B.V.
PY - 2024/5
Y1 - 2024/5
N2 - Background and aims: Subclinical cardiovascular disease (CVD) measures may reflect biological pathways that contribute to increased risk for coronary heart disease (CHD) events, stroke, and dementia beyond conventional risk scores. Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) followed 6814 participants (45–84 years of age) from baseline in 2000–2002 to 2018 over 6 clinical examinations and annual follow-up interviews. MESA baseline subclinical CVD procedures included: seated and supineblood pressure, coronary calcium scan, radial artery tonometry, and carotid ultrasound. Baseline subclinical CVD measures were transformed into z-scores before factor analysis to derive composite factor scores. Time to clinical event for all-cause CVD, CHD, stroke and ICD code-based dementia events were modeled using Cox proportional hazards models reported as area under the curve (AUC) with 95% Confidence Intervals (95%CI) at 10 and 15 years of follow-up. All models included all factor scores together, and adjustment for conventional risk scores for global CVD, stroke, and dementia. Results: After factor selection, 24 subclinical measures aggregated into four distinct factors representing: blood pressure, atherosclerosis, arteriosclerosis, and cardiac factors. Each factor significantly predicted time to CVD events and dementia at 10 and 15 years independent of each other and conventional risk scores. Subclinical vascular composites of atherosclerosis and arteriosclerosis best predicted time to clinical events of CVD, CHD, stroke, and dementia. These results were consistent across sex and racial and ethnic groups. Conclusions: Subclinical vascular composites of atherosclerosis and arteriosclerosis may be useful biomarkers to inform the vascular pathways contributing to events of CVD, CHD, stroke, and dementia.
AB - Background and aims: Subclinical cardiovascular disease (CVD) measures may reflect biological pathways that contribute to increased risk for coronary heart disease (CHD) events, stroke, and dementia beyond conventional risk scores. Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) followed 6814 participants (45–84 years of age) from baseline in 2000–2002 to 2018 over 6 clinical examinations and annual follow-up interviews. MESA baseline subclinical CVD procedures included: seated and supineblood pressure, coronary calcium scan, radial artery tonometry, and carotid ultrasound. Baseline subclinical CVD measures were transformed into z-scores before factor analysis to derive composite factor scores. Time to clinical event for all-cause CVD, CHD, stroke and ICD code-based dementia events were modeled using Cox proportional hazards models reported as area under the curve (AUC) with 95% Confidence Intervals (95%CI) at 10 and 15 years of follow-up. All models included all factor scores together, and adjustment for conventional risk scores for global CVD, stroke, and dementia. Results: After factor selection, 24 subclinical measures aggregated into four distinct factors representing: blood pressure, atherosclerosis, arteriosclerosis, and cardiac factors. Each factor significantly predicted time to CVD events and dementia at 10 and 15 years independent of each other and conventional risk scores. Subclinical vascular composites of atherosclerosis and arteriosclerosis best predicted time to clinical events of CVD, CHD, stroke, and dementia. These results were consistent across sex and racial and ethnic groups. Conclusions: Subclinical vascular composites of atherosclerosis and arteriosclerosis may be useful biomarkers to inform the vascular pathways contributing to events of CVD, CHD, stroke, and dementia.
KW - Aging
KW - Cardiovascular risk
KW - Cognition
KW - Racial/ethnic differences
KW - Subclinical cardiovascular disease
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U2 - 10.1016/j.atherosclerosis.2024.117521
DO - 10.1016/j.atherosclerosis.2024.117521
M3 - Article
C2 - 38552474
AN - SCOPUS:85188961077
SN - 0021-9150
VL - 392
JO - Atherosclerosis
JF - Atherosclerosis
M1 - 117521
ER -