Coronary calcification detected by electron-beam computed tomography and myocardial infarction. The Rotterdam Coronary Calcification Study

Vliegenthart, R.; Oudkerk, Matthijs; Song, Bin; Kuip, Deirdre A. M. van der; Hofman, Albert; Witteman, J.C.M.

doi:10.1053/euhj.2002.3240

Cited by 141 publications

(73 citation statements)

References 30 publications

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“…154 Using electron beam computed tomography, intimal calcification has been reported to affect at least one third of women and half of men over the age of 45. 155 By the age of 70, nearly all patients show some evidence of vascular calcification 156 and the presence of calcification in the coronary arteries, 157,158 or the aortic arch 159 predicts a two to eightfold increase in the risk of coronary events. Intimal calcification is believed to affect plaque mechanics and susceptibility to rupture, although this issue remains highly controversial.…”

Section: Atherosclerotic Calcificationmentioning

confidence: 99%

Collagens in the progression and complications of atherosclerosis

et al. 2009

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Collagens constitute a major portion of the extracellular matrix in the atherosclerotic plaque, where they contribute to the strength and integrity of the fibrous cap, and also modulate cellular responses via specific receptors and signaling pathways. This review focuses on the diverse roles that collagens play in atherosclerosis; regulating the infiltration and differentiation of smooth muscle cells and macrophages; controlling matrix remodeling through feedback signaling to proteinases; and influencing the development of atherosclerotic complications such as plaque rupture, aneurysm formation and calcification. Expanding our understanding of the pathways involved in cell-matrix interactions will provide new therapeutic targets and strategies for the diagnosis and treatment of atherosclerosis.

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Section: Atherosclerotic Calcificationmentioning

confidence: 99%

Collagens in the progression and complications of atherosclerosis

et al. 2009

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“…Diabetes mellitus and hypertension were defined according to the World Health Organization (WHO Diabetes mellitus 1985, WHO 1999) criteria. The prevalence of myocardial infarction was assessed by hospital discharge diagnosis or in case a patient was not hospitalized, when signs and symptoms were reports, analysis of the standard 12-lead ECG and cardiac enzyme data were diagnostic of a myocardial infarction (Bots et al 1997, Vliegenthart et al 2002. The prevalence of heart failure was assessed by the presence of suggestive signs and symptoms as described previously (Mosterd et al 1999, Bleumink et al 2004).…”

Section: Covariatesmentioning

confidence: 99%

High free thyroxine levels are associated with QTc prolongation in males

Noord¹,

Deure²,

Sturkenboom³

et al. 2008

Journal of Endocrinology

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The literature on the effect of excess thyroid hormone on ventricular repolarization is controversial. To study whether free thyroxine (T 4 ) and TSH are associated with QTc prolongation we conducted population-based cohort study. This study was conducted as part of the Rotterdam Study and included 365 men and 574 women aged 55 years and older with an electrocardiogram, who were randomly sampled for the assessment of thyroid status (free T 4 /TSH) at baseline, after exclusion of participants with hypothyroidism, use of antithyroid drugs, thyroid hormones or digoxin, left ventricular hypertrophy, and left and right bundle branch block. Endpoints were the length of the QTc interval and risk of borderline QTc prolongation. The associations were examined by means of linear and logistic regression analysis, adjusted for age and gender, diabetes mellitus, myocardial infarction, hypertension, and heart failure. Overall, there was no significant association between TSH and QTc interval (0 . 8 ms (95% confidence interval (CI) K3 . 5, 5 . 2) in the first quintile compared with the fifth quintile). Subjects in the fifth quintile of free T 4 did not have an increased QTc interval (3 . 2 ms (95% CI K1 . 1, 7 . 6)); stratification on gender showed an increment of 10 . 9 ms (95% CI 3 . 4, 18 . 3) in the fifth quintile in men and 1 . 1 ms (95% CI K4 . 2, 6 . 3) in the fifth quintile of free T 4 in women. When compared with subjects in the first quintile, male subjects in the fifth quintile of free T 4 had a significantly increased risk of a borderline QTc interval and QTc prolongation (odds ratio 2 . 40 (95% CI 1 . 20, 4 . 80)). High levels of free T 4 are associated with substantial QTc prolongation in men of up to 10 ms. The fact that free T 4 is also associated with a significantly increased risk of borderline and prolonged QTc values with its risk of sudden cardiac death, endorses the clinical importance of our findings.

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“…The use of ultrafast electronbeam computed tomography (EBCT) scans to measure vascular calcium has now made this possible. Calcification of the coronary artery intima (CAC) is closely associated with atherosclerosis (21) and appears to be an important predictor of future CVD events (22)(23)(24)(25)(26)(27). In one published study of CAC performed in Hispanics and NHWs who were referred for suspicion of CVD, coronary angiography was performed.…”

mentioning

confidence: 99%

Reduced Coronary Artery and Abdominal Aortic Calcification in Hispanics With Type 2 Diabetes

Reaven¹,

Sacks²

2004

Diabetes Care

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OBJECTIVE -To compare lifestyle factors, cardiovascular risk factors, and coronary artery calcium (CAC) and abdominal aortic calcium (AAC) levels in Hispanic and non-Hispanic white (NHW) individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS -We recently demonstrated in a small group of nonreferred, healthy, nondiabetic subjects that CAC was reduced in Hispanics compared with NHWs, despite a worse cardiovascular risk factor profile. In this study, we evaluated whether this ethnic disparity in vascular calcification was present in individuals with type 2 diabetes and in several different arterial beds. Hispanic and NHW subjects (n ϭ 245) with type 2 diabetes were evaluated for cardiovascular risk factors using questionnaires and assays of plasma biomarkers. CAC and AAC were measured by electron-beam computer-assisted tomography.RESULTS -Although Hispanics were slightly younger than NHWs, other standard risk factors and novel cardiovascular risk factors, including plasminogen activator-1 and fibrinogen levels, were similar between the groups. Despite the similar risk factor profile, the prevalence of cardiovascular disease (CVD) and mean and median levels of CAC and AAC were lower in Hispanics. Furthermore, the distribution of these calcium scores differed from that of NHWs (P Ͻ 0.05), with significantly fewer Hispanic subjects having high CAC or AAC scores. These differences were not explained by differences in CVD prevalence or any measured lifestyle or risk factor.CONCLUSIONS -Hispanics with type 2 diabetes have reduced CAC and AAC levels compared with NHW subjects, suggesting a reduction in the overall burden of vascular calcification and atherosclerosis. These data are consistent with the notion that Hispanics are protected against the development of CVD. Diabetes Care 27:1115-1120, 2004N umerous studies over the past several decades, using vital statistics data, have demonstrated reduced rates of total and cardiovascular mortality in Hispanics (1-4). Interestingly, epidemiological studies of cardiovascular risk factors have suggested that Hispanics are frequently more obese and insulin resistant compared with non-Hispanic whites (NHWs) and often, as a result, have higher triglyceride levels and lower HDL cholesterol levels (5-13). This apparent decreased rate of cardiovascular disease (CVD) in Hispanics, despite evidence of increased levels of several traditional and nontraditional risk factors, has been described as the "Hispanic paradox" (14,15). However, in several recent longitudinal cohort studies, rates of CVD have appeared equal or possibly greater in Hispanics compared with their NHW counterparts (16 -20). It is important to note that in several of these studies, the comparison between ethnic groups may have been complicated by the greater prevalence and incidence of diabetes in the Hispanic population, which may greatly enhance the overall cardiovascular risk of this ethnic group in comparison with groups having reduced rates of diabetes.To further assess this potential ethnic disparity in th...

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Coronary calcification detected by electron-beam computed tomography and myocardial infarction. The Rotterdam Coronary Calcification Study

Abstract: A strong and graded association was found between coronary calcification and myocardial infarction. The association remained at high ages.

Cited by 141 publications

References 30 publications

Collagens in the progression and complications of atherosclerosis

Collagens in the progression and complications of atherosclerosis

High free thyroxine levels are associated with QTc prolongation in males

Reduced Coronary Artery and Abdominal Aortic Calcification in Hispanics With Type 2 Diabetes

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