背景:关于不同部位动脉硬化性钙化与心房颤动(AF)的性别差异和相关性的基于人群的数据有限。我们旨在调查普通人群中不同部位的动脉硬化钙化与房颤风险之间的(性别特异性)关联。
方法:在2003-2006年间,在基于人群的鹿特丹研究的2,259名无房颤的参与者中,使用CT检查对动脉粥样硬化钙化进行了量化。Cox比例风险模型,调整心血管危险因素,用于评估冠状动脉钙化(CAC)体积的关联,主动脉弓钙化(AAC),颈动脉外和颅内动脉,椎基底动脉,和主动脉瓣伴有房颤。
结果:在平均8.6年的随访中,发生182例房颤事件。较大的CAC与房颤相关(危险比(HR),95%CI,1.25,1.09-1.44,p=0.0019)。性别分层分析表明,男性的CAC较大(HR,95%CI,1.43,1.10-1.86,p=0.0068)和女性较大的AAC与房颤相关(HR,95%CI,1.44,1.04-2.01,p=0.0299)。
结论:一般人群中的CAC,尤其是男性和女性的AAC与新发房颤显著相关.我们的研究结果表明,降低动脉硬化钙化的干预措施,特别是CAC,在一般人群中具有预防房颤的潜力,尤其是男性。
BACKGROUND: Limited population-based data on the sex differences and association between arteriosclerotic calcification at different sites and atrial fibrillation (AF) exist. We aimed to investigate the (sex-specific) associations between arteriosclerotic calcification at different sites with the risk of AF in the general population.
METHODS: Arteriosclerotic calcification was quantified using CT-examinations between 2003-2006 in 2,259 participants free of AF from the population-based Rotterdam Study. Cox proportional hazards models, adjusted for cardiovascular risk factors, was used to assess the associations of volumes of coronary artery calcification (CAC), aortic arch calcification (AAC), extra- and intracranial carotid arteries, vertebrobasilar arteries, and the aortic valve with incident AF.
RESULTS: During a median follow-up of 8.6 years, 182 incident AF cases occurred. Larger CAC was associated with incident AF (hazard ratio (HR), 95% CI, 1.25, 1.09-1.44, p=0.0019). Sex-stratified analyses showed that larger CAC among men (HR, 95% CI, 1.43, 1.10-1.86, p=0.0068) and larger AAC among women were associated with incident AF (HR, 95% CI, 1.44, 1.04-2.01, p=0.0299).
CONCLUSIONS: CAC in the general population, especially among men and AAC among women were significantly associated with new-onset AF. Our findings imply that interventions to lower arteriosclerotic calcification, in particular CAC, carry potential for prevention of AF in the general population, especially among men.