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Associations between reflux esophagitis and the progression of coronary artery calcification: A cohort study.

ABSTRACT: Reflux esophagitis (RE) and coronary heart disease (CHD) have common risk factors, including obesity and metabolic syndrome. This study aimed to evaluate the associations between RE and the future CHD risk.This retrospective cohort study included 8,221 participants who were ?20 years old, and who underwent esophagogastroduodenoscopy and coronary computed tomography (CT) scans during the same visit and subsequent CT scans between 2003 and 2013. RE was defined as the presence of at least Los Angeles classification grade A mucosal break. CT scan was used to determine the coronary artery calcium (CAC) scores. CAC progression was defined as an increase in the CAC score on a subsequent CT scan.RE was present in 984 (12.0%) participants. RE at baseline was associated with CAC progression (odds ratio [OR], 1.253; 95% confidence interval [CI], 1.088-1.444; P = 0.002), and this association persisted after adjusting the model for age, sex, smoking status, and alcohol consumption (OR, 1.175; 95% CI, 1.001-1.378; P = 0.048). This association disappeared when the model was further adjusted for body mass index, diastolic blood pressure, the presence of hypertension, glycated hemoglobin, low-density lipoprotein cholesterol, and triglycerides (OR, 1.088; 95% CI, 0.924-1.281; P = 0.311) which were selected using a stepwise selection procedure from several metabolic variables.Our results suggest that the presence of RE is closely associated with CHD, even though RE is not a direct risk factor for CHD. Metabolic factors may play roles in CAC progression in individuals with RE.

SUBMITTER: Min YW

PROVIDER: S-EPMC5628814 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Associations between reflux esophagitis and the progression of coronary artery calcification: A cohort study.

Min Yang Won YW Song Byeong Geun BG Kim Hye Seung HS Kim Kyunga K Lee Hyuk H Min Byung-Hoon BH Lee Jun Haeng JH Son Hee Jung HJ Rhee Poong-Lyul PL Kim Jae J JJ

PloS one 20171005 10

<h4>Background</h4>Reflux esophagitis (RE) and coronary heart disease (CHD) have common risk factors, including obesity and metabolic syndrome. This study aimed to evaluate the associations between RE and the future CHD risk.<h4>Methods</h4>This retrospective cohort study included 8,221 participants who were ≥20 years old, and who underwent esophagogastroduodenoscopy and coronary computed tomography (CT) scans during the same visit and subsequent CT scans between 2003 and 2013. RE was defined as ...[more]

PMID: 28981523

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Project description:BackgroundDyslipidemia is a well-known risk factor for cardiovascular disease (CVD). Recently, atherogenic index of plasma (AIP) has been proposed as a novel predictive marker for CVD, and few cross sectional studies have demonstrated a relationship between AIP and coronary artery disease. The present study investigated the association between AIP and the progression of coronary artery calcification (CAC) in Korean adults without CVD.MethodsA total of 1124 participants who had undergone CAC measurement at least twice by multi-detector computed tomography (CT) at a health check-up center were enrolled. Their anthropometric measurements and various cardiovascular risk factors were assessed. AIP was defined as the base 10 logarithm of the ratio of the concentration of triglyceride (TG) to high-density lipoprotein-cholesterol (HDL-C). CAC progression was defined as either incident CAC in a CAC-free population at baseline, or an increase of ≥2.5 units between the square roots of the baseline and follow-up coronary artery calcium scores (CACS) in subjects with detectable CAC at baseline.ResultsCAC progression was observed in 290 subjects (25.8%) during the mean follow-up of 4.2 years. All subjects were stratified into three groups according to AIP. There were significant differences in cardiovascular parameters among groups at baseline. The follow-up CAC and the incidence of CAC progression increased gradually with rising AIP tertiles. In logistic regression analysis, the odds ratio for CAC progression was 2.27 when comparing the highest to the lowest tertile of AIP (95% CI: 1.61-3.19; P for trend < 0.01). However, this association was attenuated after adjustment for multiple risk factors (P for trend = 0.67).ConclusionsThere is a significant correlation between AIP and the progression of CAC in subjects without CVD. Although AIP was not an independent predictor of CAC progression, AIP should be considered when estimating the current as well as future CVD risk, along with other traditional risk factors.

Project description:Background Positron emission tomography (PET) using 18F-sodium fluoride (18F-fluoride) to detect microcalcification may provide insight into disease activity in coronary atherosclerosis. This study aimed to investigate the relationship between 18F-fluoride uptake and progression of coronary calcification in patients with clinically stable coronary artery disease. Methods Patients with established multivessel coronary atherosclerosis underwent 18F-fluoride PET-computed tomography angiography and computed tomography calcium scoring, with repeat computed tomography angiography and calcium scoring at one year. Coronary PET uptake was analyzed qualitatively and semiquantitatively in diseased vessels by measuring maximum tissue-to-background ratio. Coronary calcification was quantified by measuring calcium score, mass, and volume. Results In a total of 183 participants (median age 66 years, 80% male), 116 (63%) patients had increased 18F-fluoride uptake in at least one vessel. Individuals with increased 18F-fluoride uptake demonstrated more rapid progression of calcification compared with those without uptake (change in calcium score, 97 [39-166] versus 35 [7-93] AU; P<0.0001). Indeed, the calcium score only increased in coronary segments with 18F-fluoride uptake (from 95 [30-209] to 148 [61-289] AU; P<0.001) and remained unchanged in segments without 18F-fluoride uptake (from 46 [16-113] to 49 [20-115] AU; P=0.329). Baseline coronary 18F-fluoride maximum tissue-to-background ratio correlated with 1-year change in calcium score, calcium volume, and calcium mass (Spearman ρ=0.37, 0.38, and 0.46, respectively; P<0.0001 for all). At the segmental level, baseline 18F-fluoride activity was an independent predictor of calcium score at 12 months (P<0.001). However, at the patient level, this was not independent of age, sex, and baseline calcium score (P=0.50). Conclusions Coronary 18F-fluoride uptake identifies both patients and individual coronary segments with more rapid progression of coronary calcification, providing important insights into disease activity within the coronary circulation. At the individual patient level, total calcium score remains an important marker of disease burden and progression. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02110303.

Project description:RATIONALE & OBJECTIVE:Coronary artery calcification (CAC) is prevalent among patients with chronic kidney disease (CKD) and increases risks for cardiovascular disease events and mortality. We hypothesized that a novel serum measure of calcification propensity is associated with CAC among patients with CKD stages 2 to 4. STUDY DESIGN:Prospective cohort study. SETTING & PARTICIPANTS:Participants from the Chronic Renal Insufficiency Cohort (CRIC) Study with baseline (n=1,274) and follow-up (n=780) CAC measurements. PREDICTORS:Calcification propensity, quantified as transformation time (T50) from primary to secondary calciprotein particles, with lower T50 corresponding to higher calcification propensity. Covariates included age, sex, race/ethnicity, clinical site, estimated glomerular filtration rate, proteinuria, diabetes, systolic blood pressure, number of antihypertensive medications, current smoking, history of cardiovascular disease, total cholesterol level, and use of statin medications. OUTCOMES:CAC prevalence, severity, incidence, and progression. ANALYTICAL APPROACH:Multivariable-adjusted generalized linear models. RESULTS:At baseline, 824 (65%) participants had prevalent CAC. After multivariable adjustment, T50 was not associated with CAC prevalence but was significantly associated with greater CAC severity among participants with prevalent CAC: 1-SD lower T50 was associated with 21% (95% CI, 6%-38%) greater CAC severity. Among 780 participants followed up an average of 3 years later, 65 (20%) without baseline CAC developed incident CAC, while 89 (19%) with baseline CAC had progression, defined as annual increase≥100 Agatston units. After multivariable adjustment, T50 was not associated with incident CAC but was significantly associated with CAC progression: 1-SD lower T50 was associated with 28% (95% CI, 7%-53%) higher risk for CAC progression. LIMITATIONS:Potential selection bias in follow-up analyses; inability to distinguish intimal from medial calcification. CONCLUSIONS:Among patients with CKD stages 2 to 4, higher serum calcification propensity is associated with more severe CAC and CAC progression.

Dataset Information

Associations between reflux esophagitis and the progression of coronary artery calcification: A cohort study.

Publications

Associations between reflux esophagitis and the progression of coronary artery calcification: A cohort study.

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