Change in cardiometabolic score and incidence of cardiovascular disease: the multi-ethnic study of atherosclerosis

详细信息    查看全文

• 作者：Sharon Stein Merkin ; PhD ; MHS^a ; ^{smerkin@mednet.ucla.edu" class="auth_mail" title="E-mail the corresponding author} ; Arun Karlamangla ; MD ; PhD^a ; David Elashoff ; PhD^b ; Tristan Grogan ; MS^b ; Teresa Seeman ; PhD^a
• 关键词：Cardiometabolic index ; Cardiovascular disease
• 刊名：Annals of Epidemiology
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：25
• 期：12
• 页码：912-917.e1
• 全文大小：449 K

文摘

Examine the relationship between changes in cardiometabolic risk profiles and subsequent cardiovascular disease (CVD).

Methods

The study sample included 5557 Multi-Ethnic Study of Atherosclerosis participants, recruited in 2000 from six U.S. counties. Standardized scores were calculated for metabolic and cardiovascular components relative to accepted clinical cut points and summed to create an index of cardiometabolic risk. CVD events and/or deaths were assessed after examination 3 (years, 2004–2005) through December 2011. Cox proportional hazards models were used to examine the association between change in the cardiometabolic index (examination 3 minus examination 1) and subsequent cardiovascular outcomes adjusted for demographics, socioeconomic status, medication, and stratified by tertiles of baseline cardiometabolic risk.

Results

We found a 31% relative increase in the CVD event rate per SD change in the cardiometabolic index among those in the highest tertile of baseline cardiometabolic risk (Hazard ratio = 1.31, 95% CI = 1.14–1.50); associations were not statistically significant in the lower tertiles of baseline risk.

Conclusions

We found that larger increases in the cardiometabolic index over time were significantly associated with higher risk for subsequent CVD events among those with elevated cardiometabolic risk at baseline. These findings highlight the importance of monitoring temporal changes in risk factor profiles for predicting cardiovascular outcomes.