动脉钙化量与假黄瘤弹性体发生心血管事件的较高风险有关

IF 4.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Atherosclerosis Pub Date : 2024-11-09 DOI:10.1016/j.atherosclerosis.2024.119051

Iris M. Harmsen , Frank L.J. Visseren , Madeleine Kok , Pim A. de Jong , Wilko Spiering

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引用次数: 0

摘要

背景和目的假黄瘤（PXE）患者因ABCC6基因突变导致无机焦磷酸水平降低而出现更多动脉钙化，但其与血管并发症的关系却鲜为人知。由于 PXE 患者的动脉疾病进展缓慢，因此需要一个有效可靠的中间终点，用于未来的临床试验。如果计算机断层扫描（CT）测量的动脉钙化与未来的心血管事件有关，那么它就是一个很有希望的候选指标。在这项前瞻性队列研究中，我们纳入了荷兰乌特勒支UMC PXE专家中心（UECP）的PXE患者。通过低剂量全身 CT 扫描测量动脉钙化体积。对患者的心血管事件进行随访。结果在 326 名患者（中位数随访 6.0 年，IQR 3.8-8.2 年）中观察到 41 例心血管事件（每 1000 人年 21 例）。在无心血管病史的患者中，基线动脉钙化体积对数与未来心血管事件之间存在显著关系（动脉钙化每增加 1 对数单位，调整后 HR：1.87，95 % CI：1.14-3.09）。结论PXE患者CT上较高的动脉钙化量与较高的首次心血管事件风险有关。这项队列研究表明，在评估降低心血管事件风险的干预措施的研究中，动脉钙化可作为中间终点。

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Arterial calcification volume is associated with a higher risk of cardiovascular events in pseudoxanthoma elasticum

Background and aims

Pseudoxanthoma elasticum (PXE) patients have more arterial calcification due to lower levels of inorganic pyrophosphate, caused by mutations in the ABCC6 gene, but the relation with vascular complications is poorly understood. Because of the slow progressing nature of arterial disease in PXE patients, there is a need for a valid and reliable intermediate endpoint to be used in future clinical trials. Arterial calcification measured on computed tomography (CT) is a promising candidate, if associated with future cardiovascular events. We aimed to establish the relation between arterial calcification measured on CT and future cardiovascular events in patients with PXE.

Methods

In this prospective cohort study, patients with PXE from the Dutch UMC Utrecht Expertise Center for PXE (UECP) were included. Arterial calcification volume was measured on low dose full body CT scans. Patient were followed for incident cardiovascular events. The relation between arterial calcification and the risk of cardiovascular events was analyzed using Cox proportional hazard models.

Results

In 326 patients (median follow-up 6.0, IQR 3.8–8.2 years) 41 cardiovascular events were observed (21 events per 1000 person years). In patients with no cardiovascular history, there was a significant relation between the log arterial calcification volume at baseline and future cardiovascular events (adjusted HR: 1.87, 95 % CI: 1.14–3.09, per 1 log unit increase in arterial calcification). There was no relation in patients with clinical manifest cardiovascular disease at baseline between arterial calcification volume and future cardiovascular events.

Conclusions

Higher arterial calcification volumes on CT in PXE patients are associated with a higher risk of a first cardiovascular event. This cohort study suggests that arterial calcification can be used as an intermediate endpoint in studies evaluating interventions to lower the risk of cardiovascular events.

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来源期刊

Atherosclerosis 医学-外周血管病

CiteScore

9.80

自引率

3.80%

发文量

1269

审稿时长

36 days

期刊介绍： Atherosclerosis has an open access mirror journal Atherosclerosis: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Atherosclerosis brings together, from all sources, papers concerned with investigation on atherosclerosis, its risk factors and clinical manifestations. Atherosclerosis covers basic and translational, clinical and population research approaches to arterial and vascular biology and disease, as well as their risk factors including: disturbances of lipid and lipoprotein metabolism, diabetes and hypertension, thrombosis, and inflammation. The Editors are interested in original or review papers dealing with the pathogenesis, environmental, genetic and epigenetic basis, diagnosis or treatment of atherosclerosis and related diseases as well as their risk factors.