Table 3.
Association of Elevated Levels of Novel ASCVD Risk Markers and Presence of Extracoronary Atherosclerosis With Incident CAC
| Risk Markera | All (N = 815) |
Men (n = 270) |
Women (n = 545) |
|||
|---|---|---|---|---|---|---|
| HR (95% CI) | P Value | HR (95% CI) | P Value | HR (95% CI) | P Value | |
| Atherogenic | ||||||
| Apo-B >130 mg/dL | 1.00 (0.70-1.44) | 0.98 | 1.11 (0.60-2.03) | 0.75 | 1.17 (0.73-1.87) | 0.50 |
| Elevated Lp(a)b | 0.82 (0.59-1.14) | 0.24 | 0.90 (0.50-1.60) | 0.71 | 0.74 (0.49-1.12) | 0.15 |
| Myocardial | ||||||
| Hs-cTnT >3 ng/mL | 1.05 (0.81-1.35) | 0.73 | 1.52 (0.85-2.74) | 0.16 | 0.94 (0.70-1.26) | 0.67 |
| NT-proBNP >125 mg/dL | 1.19 (0.90-1.60) | 0.22 | 2.07 (1.18-3.65) | 0.01 | 1.01 (0.73-1.41) | 0.94 |
| Renal | ||||||
| eGFR <60 mL/min/1.73 m2 | 0.86 (0.64-1.14) | 0.28 | 1.20 (0.72-2.01) | 0.48 | 0.75 (0.53-1.06) | 0.11 |
| Urinary albumin-creatinine ratio >30 mg/g | 1.50 (1.07-2.09) | 0.01 | 1.56 (0.94-2.60) | 0.09 | 1.44 (0.92-2.27) | 0.11 |
| Inflammatory | ||||||
| CRP >2 mg/L | 1.02 (0.82-1.28) | 0.85 | 0.78 (0.52-1.17) | 0.24 | 1.24 (0.93-1.67) | 0.15 |
| Extracoronary atherosclerosis | ||||||
| Presence of carotid plaque | 1.32 (1.04-1.66) | 0.02 | 1.12 (0.75-1.68) | 0.57 | 1.28 (0.95-1.72) | 0.10 |
| Presence of thoracic calcification | 1.38 (1.10-1.75) | 0.006 | 1.28 (0.80-2.06) | 0.31 | 1.43 (1.08-1.89) | 0.01 |
| Ankle-brachial index <0.9 or >1.3 | 1.02 (0.64-1.62) | 0.94 | 1.20 (0.63-2.29) | 0.58 | 0.82 (0.40-1.68) | 0.59 |
| Diet and lifestyle | ||||||
| Healthy diet (yes vs no) | 1.27 (1.01-1.59) | 0.04 | 0.89 (0.61-1.29) | 0.53 | 1.58 (1.17-2.15) | 0.003 |
| Optimal physical activity (yes vs no) | 0.81 (0.56-1.18) | 0.28 | 0.94 (0.55-1.59) | 0.81 | 0.70 (0.40-1.20) | 0.19 |
Apo-B = apolipoprotein-B; ASCVD = atherosclerotic cardiovascular disease; CAC = coronary artery calcium; CRP = C-reactive protein; eGFR = estimated glomerular filtration rate; hs-cTnT = high-sensitivity cardiac troponin T; Lp(a) = lipoprotein a; NT-proBNP = N-terminal pro-brain natriuretic peptide.
Each nontraditional risk factor was evaluated independently after adjustment for age, hypertension, total cholesterol/HDL-cholesterol, type 2 diabetes, hypertriglyceridemia, abdominal obesity, cigarette smoking, antihypertensive medication, lipid-lowering medication, and glucose-lowering medication
Lp(a) >50 mg/dL for non-Hispanic White, Hispanic, and Chinese, Lp(a) >30 mg/dL for non-Hispanic Black.