 |
|
Risk Scores Predict Atherosclerotic Lesions in Young People
C. Alex McMahan, PhD;
Samuel S. Gidding, MD;
Zahi A. Fayad, PhD;
Arthur W. Zieske, MD;
Gray T. Malcom, PhD;
Richard E. Tracy, MD, PhD;
Jack P. Strong, MD;
Henry C. McGill, Jr, MD; for the Pathobiological Determinants of Atherosclerosis in Youth Research Group
Arch Intern Med. 2005;165:883-890.
Background Atherosclerosis begins in childhood and progresses through young adulthood to form the lesions that cause coronary heart disease. These preclinical lesions are associated with coronary heart disease risk factors in young persons.
Methods The Pathobiological Determinants of Atherosclerosis in Youth study collected arteries and samples of blood and other tissues from persons aged 15 to 34 years who died of external causes and underwent autopsy in forensic laboratories. We measured the coronary heart disease risk factors and atherosclerotic lesions in the coronary arteries (CAs) (n = 1117) and the abdominal aorta (n = 1458).
Results We developed risk scores, normalized so that a 1-unit increase was equivalent to a 1-year increase in age, to estimate the probability of advanced atherosclerotic lesions in the CAs and the abdominal aorta from age, sex, serum lipoprotein concentrations, smoking, hypertension, obesity, and hyperglycemia. Odds ratios for a 1-unit increase in the risk scores were 1.18 (95% confidence interval, 1.14-1.22) for the CAs and 1.29 (95% confidence interval, 1.23-1.35) for the abdominal aorta. These risk scores had good discrimination (c-indexes: 0.78 for the CAs and 0.84 for the abdominal aorta) and were calibrated. The presence of abdominal aortic lesions increased the likelihood of having CA lesions.
Conclusion Risk scores calculated from traditional coronary heart disease risk factors provide a tool for identifying young individuals with a high probability of having advanced atherosclerotic lesions.
Author Affiliations: Department of Pathology, The University of Texas Health Science Center at San Antonio (Drs McMahan and McGill); Outreach Services, Nemours Cardiac Center, Alfred I. duPont Hospital for Children, Wilmington, Del, and Department of Pediatrics, Jefferson Medical College, Philadelphia, Pa (Dr Gidding); Departments of Radiology and Medicine, Mount Sinai School of Medicine, New York, NY (Dr Fayad); Department of Pathology, Louisiana State University Health Sciences Center, New Orleans (Drs Zieske, Malcom, Tracy, and Strong); and the Department of Physiology and Medicine, Southwest Foundation for Biomedical Research, San Antonio (Dr McGill).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
ER{alpha}, ER{beta}, and gpER: novel aspects of oestrogen receptor signalling in atherosclerosis
Meyer and Barton
Cardiovasc Res 2009;83:605-610.
FULL TEXT
Prehypertension during Young Adulthood and Coronary Calcium Later in Life
Pletcher et al.
ANN INTERN MED 2008;149:91-99.
ABSTRACT
| FULL TEXT
Preventing Heart Disease in the 21st Century: Implications of the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Study
McGill et al.
Circulation 2008;117:1216-1227.
FULL TEXT
Prevalence and Determinants of Elevated Apolipoprotein B and Dense Low-Density Lipoprotein in Youths with Type 1 and Type 2 Diabetes
Albers et al.
J. Clin. Endocrinol. Metab. 2008;93:735-742.
ABSTRACT
| FULL TEXT
Drug Therapy of High-Risk Lipid Abnormalities in Children and Adolescents: A Scientific Statement From the American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee, Council of Cardiovascular Disease in the Young, With the Council on Cardiovascular Nursing
McCrindle et al.
Circulation 2007;115:1948-1967.
ABSTRACT
| FULL TEXT
Cardiovascular Risk Reduction in High-Risk Pediatric Patients: A Scientific Statement From the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research: Endorsed by the American Academy of Pediatrics
Kavey et al.
Circulation 2006;114:2710-2738.
ABSTRACT
| FULL TEXT
Prediction of Coronary Artery Calcium in Young Adults Using the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Risk Score: The CARDIA Study
Gidding et al.
Arch Intern Med 2006;166:2341-2347.
ABSTRACT
| FULL TEXT
Pathobiological Determinants of Atherosclerosis in Youth Risk Scores Are Associated With Early and Advanced Atherosclerosis
McMahan et al.
Pediatrics 2006;118:1447-1455.
ABSTRACT
| FULL TEXT
New Cholesterol Guidelines for Children?
Gidding
Circulation 2006;114:989-991.
FULL TEXT
Cardiovascular risk scores and the presence of subclinical coronary artery atherosclerosis in women with systemic lupus erythematosus
Chung et al.
Lupus 2006;15:562-569.
ABSTRACT
|
