The Journal of the Korea Contents Association (한국콘텐츠학회논문지)

The Korea Contents Association (한국콘텐츠학회)
권호 표지
DOI QR코드

DOI QR Code

Association of Coronary Artery Calcium Scores with Cadiovascular Disease Risk Factors in an Asymptomatic Adults

무증상 성인에서 심혈관질환 위험요소와 관상동맥 석회 수치와의 관계

  • 문일봉 (전남대학교병원 영상의학과) ;
  • 손석준 (한국농촌의학회, 대한예방의학회)
  • Received : 2010.04.27
  • Accepted : 2010.06.09
  • Published : 2010.07.28
Download PDF
⟨ Previous Next ⟩

Abstract

Coronary artery calcium scores(CACS) has been used as surrogate marker for coronary atherosclerosis. We evaluated 1042 patients who visited the Department of Health Promotion Center in Chonnam National University Hospital and had a test of the CACS from January 2006, to December 2008. This study was performed to evaluate the relation of the CACS with Cadiovascular disease(CVD) risk factors and FRS. CACS and FRS was a significant difference between the group whose calcium score was 0 and the group whose calcium scores were 1 in case of men 2.38(95% CI, 1.83-3.11), women 2.12(95% CI, 1.03-4.35). The age-and sex-adjusted odds ratios for predictor of CVD risk factors to women with age was 1.10(95% CI, 1.06-1.15), HDL-cholesterol was 2.38(95% CI, 1.04-5.44), Fasting plasma glucose was 2.89(95% CI, 1.16-7.21), to men with age was 1.11(95% CI, 1.08-1.14), LDL-cholesterol was 2.12(95% CI, 1.28-3.50), gamma-GTP was 1.73(95% CI, 1.17-2.55), Diabetes mellitus medication was 3.92(95% CI, 1.73-8.89). The CACS seems to be a siginificant factor to evaluate the CVD risk factors.

관상동맥 석회수치(CACS)는 조직학적으로 동맥경화반의 총량과 높은 상관관계를 보이며, 관상동맥의 협착을 예측하는 지표와 향후 허혈성 심장질환 발생의 독립적인 위험인자가 된다. 본 연구는 2006년 1월부터 2008년 12월까지 화순전남대학교병원 건강증진센터에서 건강검진을 목적으로 CACS검사를 시행한 1042명을 대상자로 심혈관질환 위험요소 및 관상동맥 석회수치와 Framingham Risk Scores(FRS)와의 상관관계를 알아보고자 하였다. CACS와 FRS는 남성(OR, 2.38; 95% CI, 1.83-3.11), 여성(OR, 2.12; 95% CI, 1.03-4.35) 모두 관상동맥 석회수치가 없는 군과 비교하여 통계적으로 유의하게 높았으며, CACS와 심혈관질환 위험요인과의 관계에서는 연령과 성별을 통제한 다변량분석에서 여자는 연령(OR, 1.10; 95% CI, 1.06-1.15), 고밀도지단백콜레스테롤(OR, 2.38; 95% CI, 1.04-5.44), 공복혈당(OR, 2.89; 95% CI, 1.16-7.21)이 남자에서는 연령(OR, 1.11; 95% CI, 1.08-1.14), 저밀도지단백콜레스테롤(OR, 2.12; 95% CI, 1.28-3.50), 감마-글루타밀전이효소(OR, 1.73; 95% CI, 1.17-2.55), 당뇨병(OR, 3.92; 95% CI, 1.73-8.89)이 관상동맥 석회수치의 유의한 위험인자로 나타났다.

Keywords

References

  1. V. Fuster, L. Badimon, J. J. Badimon, and J. H. Chesebro, The pathogenesis of coronary artery disease and the acute coronary syndromes (1), N Engl J Med 326, pp.242-250, 1992. https://doi.org/10.1056/NEJM199201233260406
  2. R. Virmani, A. P. Burke, A. Farb, and F. D. Kolodgie, Pathology of the unstable plaque, Prog Cardiovasc Dis, Vol.44, No.5, pp.349-356, 2002. https://doi.org/10.1053/pcad.2002.122475
  3. D. P. Zipes and H. J. Wellnes, Sudden cardiac death, Circulation 98, pp.2334-2351, 1998. https://doi.org/10.1161/01.CIR.98.21.2334
  4. Z. J. Zheng, J. B. Croft, W. H. Giles, C. I. Ayala, K. J. Greenlund, and N. L. Keenan, State-specific mortality from sudden cardiac death-United States, 1999, MMWR Morb Mortal Wkly Rep 51, pp.123-126, 2002.
  5. S. L. Mautner, G. C. Mautner, and J. Froehlich, Coronary artery disease: prediction with in vitro electron beam CT, Radiology 192, pp.625-630, 1994. https://doi.org/10.1148/radiology.192.3.8058925
  6. J. A. Rumberger, D. B. Simons, L. A. Fitzpatrick, P. F. Sheedy, and R. S. Schwartz, Coronary artery calcium area by electron-beam computed tomograp hy and coronary atherosclerotic plaque area: a histopathologic correlative study, Circulation 92, pp.2157-2162, 1995. https://doi.org/10.1161/01.CIR.92.8.2157
  7. G. Sangiorgi, J. A. Rumberger, and A. Severson, Arterial calcification and not lumen stenosis is highly correlated with atherosclerotic plaque burden in humans: a histologic study of 723 coronary artery segments using nondecalcifying methodology, J Am Coll Cardiol 31, pp.126-133, 1998. https://doi.org/10.1016/S0735-1097(98)81191-1
  8. 최규옥, 관동맥 석회치 검사의 역할: 폐쇄성 관동맥 질환의 예방 및 조기 발견, 순환기학회지 27호, pp.566-577, 1997.
  9. M. Naghavi, E. Falk, H. S. Hecht, M. J. Jamieson, S. Kaul, and D. Berman, Fromvulnerable plaque to vulnerable patient-part III: executive summary of the Screening for Heart Attack Prevention and Education(SHAPE) Task Force Report, Am J Cardiol 98, 2H-15H, 2006. https://doi.org/10.1016/S0002-9149(06)01666-3
  10. K. M. Anderson, P. M. Odell, P. W. Wilson, and W. B. Kannel, Cardiovascular disease risk profiles, Am Heart J 121, pp.293-298, 1991. https://doi.org/10.1016/0002-8703(91)90861-B
  11. De Backer G, E. Ambrosioni, K. Borch-Johnsen, C. Brotons, R. Cifkova, and J. Dallongeville, European guidelines on cardiovascular disease prevention in clinical practice: third joint task force of European and other societies on cardio vascular disease prevention in clinical practice, Eur J Cardiovasc Prev Rehabil 10(4 Supple 1), 1-78, 2003. https://doi.org/10.1097/00149831-200308000-00004
  12. Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treat ment of high blood cholesterol in adults(Adult Treatment Panel III), JAMA 285, pp.2486-2497,2001. https://doi.org/10.1001/jama.285.19.2486
  13. P. W. Wilson, R. B. D’Agostino, D. Levy, A. M. Belanger, H. Silbershatz, and W. B. Kannel, Prediction of coronary heart disease using risk factor catego ries, Circulation 97, pp.1837-1847, 1998. https://doi.org/10.1161/01.CIR.97.18.1837
  14. J. T. Salonen and R. Salonen : Ultrasound B-mode imaging in observational studies of atheros-clerotic progression, Circulation 87(Suppl II), pp.56-65, 1993.
  15. J. A. Rumberger, B. H. Brundage, D. J. Rader, and G. Kondos: Electron beam computed tomo-graphic coronary calcium scanning: a review and guidelines for use in asymptomatic persons, Mayo Clin Proc 74, pp.243-252, 1999. https://doi.org/10.4065/74.3.243
  16. 김동희, 무증상 성인 한국인에서 관상동맥 석회수치의 연령 및 성별 분포와 특성: 심혈관 질환의 위험요인 및 대사 증후군의 관계, 대한순환기학회지 38호, pp.29-35, 2008.
  17. 문준성, 제2형 당노병환자에게서 혈청 빌리루빈과 관상동맥 죽상경화증의 관계, 대한당뇨학회 32호, pp.338-345, 2008.
  18. M. H. Gault, L. L. Longerich, J. D. Harnett, and C. Wesolo Wski, Predicting glomerular function from adjusted serum creatinine, Nephron, Vol. 62, No.3, pp.249-256, 1992. https://doi.org/10.1159/000187054
  19. Nurhan Seyahi, Arzu Kahveci, and Murat Bolayirli, Coronary Artery Calcification and Chro-nically Decreased GFR in Living Kidney Donors, American Journal of Kidney Diseasese 49, pp.143-152, 2007. https://doi.org/10.1053/j.ajkd.2006.10.016
  20. Brad C. Astor, Stein I. Hallan, Edgar R. Miller III, Edwina Yeung, Josef Coresh, Glomerular Filtration Rate, Albuminuria, and Risk of Cardiovascular and All-Cause Mortality in the US Population, American Journal of Epidemiology 167, pp.1226-1234, 2008. https://doi.org/10.1093/aje/kwn033
  21. Raul D. Santos, Khurram Nasir, Raza Orakzai, Romeu S. Meneghelo, Jose A.M. Carvalho, Roger S. Blumenthal, Relation of Uric Acid Levels to Presence of Coronary Artery Calcium Detected by Electron Beam Tomography in Men Free of Symptomatic Myocardial Ischemia With Versus Without the Metabolic Syndrome, The American Journal of Cardiology 99, pp.42-45, 2007. https://doi.org/10.1016/j.amjcard.2006.07.057
  22. Douglas S. Lee, Jane C. Evans, Sander J. Robins, Peter W. Wilson, Irene Albano, Caroline S. Fox, Thomas J. Wang, Emelia J. Benjamin, Ralph B. D'Agostino and Ramachandran S. Vasan, Gamma Glutamyl Transferase and Metabolic Syndrome, Cardiovascular Disease, and Mortality Risk: The Framingham Heart Study, Arterioscler Thromb Vasc Biol 27, pp.127-133, 2007. https://doi.org/10.1161/01.ATV.0000251993.20372.40
  23. 김영상, 관상동맥 석회수치와 Framingh am Risk Score와의 관계, 가정의학회지 29호, pp.762-767, 2008.
  24. L. A. Fitzpatrick, A. Severson, and W. D. dwards, Ingram RT. Diffuse calcification in human coronary arteries. Association of osteopontin with atherosclerosis, J Clin Invest 94, pp.1597-1604, 1994. https://doi.org/10.1172/JCI117501
  25. N. D. Wong, J. C. Hsu, R. C. Detrano, G. Diamond, H. Eisenberg, and J. M. Gardin. Coronary artery calci um evaluation by electron beam computed tomo graphy and its relation to new cardiovascular events, Am J Cardiol 86, pp.495-498, 2000. https://doi.org/10.1016/S0002-9149(00)01000-6
  26. M. Ward, H. Mcnulty, J . Mcpartlin, J. J. Strain, D. G. Weir, and J. M. Scott, Plasma homocysteine, a risk factor for cardiovascular disease, is lowered by physiological doses of folic acid, Q J Med 90, pp.519-524, 1997. https://doi.org/10.1093/qjmed/90.8.519
  27. A. Pazin-Filho, A. Kottgen, A. G. Bertoni, S. D. Russell, E. Selvin, W. D. Rosamond, and J. Coresh, HbA1c as a risk factor for heart failure in persons with diabetes: the Atherosclerosis Risk in Communities(ARIC) study, Diabetologia 51, pp.2197-2204, 2008. https://doi.org/10.1007/s00125-008-1164-z
  28. David I. Buckley, Rongwei Fu, Michele Freeman, Kevin Rogers, and Mark Helfand, C-Reactive Protein as a Risk Factor for Coronary Heart Disease: A Systematic Review and Meta-analyses for the U.S. Preventive Services Task Force, Ann Intern Med 151, pp.483-495, 2009. https://doi.org/10.7326/0003-4819-151-7-200910060-00009

Cited by

  1. Prediction of Obstructive Coronary Artery Disease by Coronary Artery Calcification Finding on Low-dose CT Image for screening of lung diseases: Compared with Calcium Scoring CT vol.11, pp.10, 2011, https://doi.org/10.5392/JKCA.2011.11.10.333