Table2.
Incidence rates and Hazard ratios (95% confidence interval) of incident heart failure associated with number of sites with valvular calcification progression, MESA, 2000–2016
| No progression | One site only (AVC or MAC) | Two sites (AVC and MAC) | Total/p-for-trend | |
|---|---|---|---|---|
| Total Heart failure | ||||
| N (row %) | 4617 (82.6%) | 827 (14.8%) | 147 (2.6%) | 5591 |
| HF; n (%) | 157 (3.4%) | 75 (9.1%) | 19 (12.9%) | 251 (4.5) |
| Person-years | 53289 | 8302 | 1366 | 62957 |
| IR (95% CI)* | 2.95 (2.52 – 3.45) | 9.03 (7.20 – 11.33) | 13.91 (8.87 – 21.81) | 3.99 (3.52 – 4.51) |
| Model 1 | 1 (reference) | 1.92 (1.44 – 2.56) | 2.33 (1.42 – 3.83) | <0.001 |
| Model 2 | 1 (reference) | 1.73 (1.30 – 2.31) | 2.07 (1.26 – 3.40) | <0.001 |
| Model 3 | 1 (reference) | 1.62 (1.21 – 2.17) | 1.88 (1.14 – 3.09) | <0.001 |
| Model 4 | 1 (reference) | 1.49 (1.11 – 2.01) | 1.62 (0.98 – 2.68) | 0.005 |
| Heart failure with preserved ejection fraction | ||||
| N (row %) | 4514 (82.9%) | 792 (14.6%) | 137 (2.5%) | 5443 |
| HFpEF; n (%) | 54 (1.2%) | 40 (5.1%) | 9 (6.6%) | 103 (1.9) |
| Person-years | 52581 | 8070 | 1308 | 61959 |
| IR (95% CI)* | 1.03 (0.79 – 1.34) | 4.96 (3.64 – 6.76) | 6.88 (3.58 – 13.22) | 1.66 (1.37 – 2.02) |
| Model 1 | 1 (reference) | 2.98 (1.93 – 4.60) | 3.23 (1.54 – 6.76) | <0.001 |
| Model 2 | 1 (reference) | 2.63 (1.71 – 4.06) | 2.65 (1.26 – 5.59) | <0.001 |
| Model 3 | 1 (reference) | 2.52 (1.63 – 3.90) | 2.49 (1.19 – 5.25) | <0.001 |
| Model 4 | 1 (reference) | 2.44 (1.57 – 3.78) | 2.27 (1.07 – 4.82) | <0.001 |
| Heart failure with reduced ejection fraction | ||||
| N (row %) | 4549 (83.3%) | 780 (14.3%) | 135 (2.5%) | 5464 |
| HFrEF; n (%) | 89 (2.0%) | 28 (3.6%) | 7 (5.2%) | 124 (2.3) |
| Person-years | 52827 | 7989 | 1307 | 62122 |
| IR (95% CI)* | 1.68 (1.37 – 2.07) | 3.51 (2.42 – 5.08) | 5.36 (2.55 – 11.23) | 2.00 (1.67 – 2.38) |
| Model 1 | 1 (reference) | 1.33 (0.85 – 2.07) | 1.57 (0.71 – 3.48) | 0.12 |
| Model 2 | 1 (reference) | 1.22 (0.78 – 1.90) | 1.47 (0.66 – 3.26) | 0.24 |
| Model 3 | 1 (reference) | 1.07 (0.68 – 1.69) | 1.28 (0.57 – 2.86) | 0.55 |
| Model 4 | 1 (reference) | 0.95 (0.60 – 1.49) | 1.05 (0.47 – 2.35) | 0.95 |
| Total Heart failure adjusting from interim CHD and AF† | ||||
| Model 1 | 1 (reference) | 1.86 (1.40 – 2.48) | 2.23 (1.36 – 3.65) | <0.001 |
| Model 2 | 1 (reference) | 1.70 (1.28 – 2.27) | 2.01 (1.23 – 3.31) | <0.001 |
| Model 3 | 1 (reference) | 1.58 (1.18 – 2.11) | 1.86 (1.13 – 3.06) | <0.001 |
| Model 4 | 1 (reference) | 1.47 (1.09 – 1.97) | 1.62 (0.98 – 2.67) | 0.01 |
AF=atrial fibrillation; CHD=coronary heart disease; CI=confidence interval; HF=heart failure; HFpEF= heart failure with preserved ejection fraction; HFrEF= heart failure with reduced ejection fraction; IR=incidence rate
unadjusted and per 1,000 person-years
Models additional adjust for interim coronary heart disease and atrial fibrillation as time-varying covariates and use time updated age
Values in bold font are statistically significant, p<0.05
Model 1: age, race/ethnicity, sex, MESA site, CT scanner type, and time between baseline & follow-up CT
Model 2: Model 1+ educational status, BMI, smoking status, pack-years of smoking, & physical activity
Model 3: Model 2 + systolic blood pressure, use of antihypertensives, use of lipid lowering medications, total cholesterol, HDL-cholesterol, diabetes status & eGFR
Model 4: Model 3 + baseline coronary calcium