OBJECTIVES: This study sought to evaluate the relationship between microalbuminuria (MA) and the development and progression of atherosclerosis, as assessed by incident and progression of coronary artery calcification (CAC). BACKGROUND: MA is associated with an increased risk of cardiovascular disease, but the mechanism by which MA imparts this increased risk is not known. METHODS: The MESA (Multi-Ethnic Study of Atherosclerosis) study is a prospective cohort study of 6,814 self-identified White, African-American, Hispanic, or Chinese participants free of clinical cardiovascular disease at entry. Of the 6,775 individuals with available urine albumin data, we excluded 97 subjects with macroalbuminuria and 1,023 with missing follow-up CAC data. The final study population consists of 5,666 subjects. RESULTS: At baseline, individuals with MA were more likely to have CAC >0 compared with those without MA (62% vs. 48%, p < 0.0001). During a mean follow-up of 2.4 +/- 0.8 years, those with MA and no CAC at baseline were more likely to develop CAC (relative risk [RR]: 2.05, 95% confidence interval [CI]: 1.41 to 3.02, p < 0.0001) as compared with those without MA in demographic-adjusted analyses. After multivariant adjustment, the relationship was attenuated but remained statistically significant (RR: 1.76, 95% CI: 1.19 to 2.61, p = 0.005). Among those with CAC at baseline, those with versus those without MA had a 15 (95% CI: 8 to 22, p < 0.0001) volume units higher median increase in CAC in demographic-adjusted analyses. After multivariant adjustment, MA remained associated with incident CAC (RR: 1.76, 95% CI: 1.19 to 2.61, p = 0.005) and with progression of CAC (median increase in CAC volume score of 9 [95% CI: 2 to 16, p = 0.009]), relative to those without MA. CONCLUSIONS: This large multiethnic, population-based study of asymptomatic individuals demonstrates an increased risk of incident CAC as well as greater CAC progression among those with MA. Further study is needed to determine the degree to which MA precedes and predicts progression of atherosclerosis and how this information can be used to reduce cardiovascular events. Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
OBJECTIVES: This study sought to evaluate the relationship between microalbuminuria (MA) and the development and progression of atherosclerosis, as assessed by incident and progression of coronary artery calcification (CAC). BACKGROUND: MA is associated with an increased risk of cardiovascular disease, but the mechanism by which MA imparts this increased risk is not known. METHODS: The MESA (Multi-Ethnic Study of Atherosclerosis) study is a prospective cohort study of 6,814 self-identified White, African-American, Hispanic, or Chinese participants free of clinical cardiovascular disease at entry. Of the 6,775 individuals with available urine albumin data, we excluded 97 subjects with macroalbuminuria and 1,023 with missing follow-up CAC data. The final study population consists of 5,666 subjects. RESULTS: At baseline, individuals with MA were more likely to have CAC >0 compared with those without MA (62% vs. 48%, p < 0.0001). During a mean follow-up of 2.4 +/- 0.8 years, those with MA and no CAC at baseline were more likely to develop CAC (relative risk [RR]: 2.05, 95% confidence interval [CI]: 1.41 to 3.02, p < 0.0001) as compared with those without MA in demographic-adjusted analyses. After multivariant adjustment, the relationship was attenuated but remained statistically significant (RR: 1.76, 95% CI: 1.19 to 2.61, p = 0.005). Among those with CAC at baseline, those with versus those without MA had a 15 (95% CI: 8 to 22, p < 0.0001) volume units higher median increase in CAC in demographic-adjusted analyses. After multivariant adjustment, MA remained associated with incident CAC (RR: 1.76, 95% CI: 1.19 to 2.61, p = 0.005) and with progression of CAC (median increase in CAC volume score of 9 [95% CI: 2 to 16, p = 0.009]), relative to those without MA. CONCLUSIONS: This large multiethnic, population-based study of asymptomatic individuals demonstrates an increased risk of incident CAC as well as greater CAC progression among those with MA. Further study is needed to determine the degree to which MA precedes and predicts progression of atherosclerosis and how this information can be used to reduce cardiovascular events. Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Authors: J Jeffrey Carr; Jennifer Clark Nelson; Nathan D Wong; Michael McNitt-Gray; Yadon Arad; David R Jacobs; Stephan Sidney; Diane E Bild; O Dale Williams; Robert C Detrano Journal: Radiology Date: 2005-01 Impact factor: 11.105
Authors: Hans Ibsen; Michael H Olsen; Kristian Wachtell; Knut Borch-Johnsen; Lars H Lindholm; Carl Erik Mogensen; Björn Dahlöf; Richard B Devereux; Ulf de Faire; Frej Fyhrquist; Stevo Julius; Sverre E Kjeldsen; Ole Lederballe-Pedersen; Markku S Nieminen; Per Omvik; Suzanne Oparil; Ying Wan Journal: Hypertension Date: 2005-01-17 Impact factor: 10.190
Authors: Jennifer Clark Nelson; Richard A Kronmal; J Jeffrey Carr; Michael F McNitt-Gray; Nathan D Wong; Catherine M Loria; Jonathan G Goldin; O Dale Williams; Robert Detrano Journal: Radiology Date: 2005-05 Impact factor: 11.105
Authors: D E Weiner; M A Carpenter; A S Levey; A Ivanova; E H Cole; L Hunsicker; B L Kasiske; S J Kim; J W Kusek; A G Bostom Journal: Am J Transplant Date: 2012-05-17 Impact factor: 8.086
Authors: Nisha Bansal; Eric Vittinghoff; Carmen A Peralta; Michael G Shlipak; Vanessa Grubbs; David R Jacobs; David Siscovick; Michael Steffes; John Jeffrey Carr; Kirsten Bibbins-Domingo Journal: Am J Epidemiol Date: 2013-06-27 Impact factor: 4.897
Authors: William Whang; James Peacock; Elsayed Z Soliman; Carmela Alcantara; Saman Nazarian; Amit J Shah; Karina W Davidson; Steven Shea; Paul Muntner; Daichi Shimbo Journal: Am J Cardiol Date: 2014-09-28 Impact factor: 2.778
Authors: Daniel H Katz; Senthil Selvaraj; Frank G Aguilar; Eva E Martinez; Lauren Beussink; Kwang-Youn A Kim; Jie Peng; Jin Sha; Marguerite R Irvin; John H Eckfeldt; Stephen T Turner; Barry I Freedman; Donna K Arnett; Sanjiv J Shah Journal: Circulation Date: 2013-09-27 Impact factor: 29.690
Authors: Arvind K Pandey; Michael J Blaha; Kavita Sharma; Juan Rivera; Matthew J Budoff; Ron Blankstein; Mouaz Al-Mallah; Nathan D Wong; Leslee Shaw; Jeffery Carr; Daniel O'Leary; Joao A C Lima; Moyses Szklo; Roger S Blumenthal; Khurram Nasir Journal: Atherosclerosis Date: 2013-12-06 Impact factor: 5.162
Authors: Simerjot Kaur Jassal; Michel Chonchol; Gail A Laughlin; Kevin M Cummins; Gerard Smits; Caroline K Kramer; Joachim H Ix; Elizabeth Barrett-Connor Journal: Am J Cardiol Date: 2012-08-08 Impact factor: 2.778
Authors: Joshua D Bundy; Jing Chen; Wei Yang; Matthew Budoff; Alan S Go; Juan E Grunwald; Radhakrishna R Kallem; Wendy S Post; Muredach P Reilly; Ana C Ricardo; Sylvia E Rosas; Xiaoming Zhang; Jiang He Journal: Atherosclerosis Date: 2018-02-10 Impact factor: 5.162