ABSTRACT
Resumen: Objetivo: La prevalencia de calcificación arterial coronaria (CAC), marcador específico de aterosclerosis, no es conocida en México. Nuestro objetivo fue investigar la prevalencia y extensión de CAC y su asociación con factores de riesgo cardiovascular en población mexicana. Métodos: La CAC fue medida por tomografía computarizada multidetector en individuos asintomáticos que participaron en el estudio Genética de la Enfermedad Aterosclerosa. Los factores de riesgo cardiovascular y los medicamentos fueron registrados. Resultados: La muestra incluyó 1,423 individuos (49.5% hombres), con una edad de 53.7 ± 8.4 años. Los portadores de CAC mostraron prevalencias más altas de dislipidemia, diabetes, hipertensión y otros factores de riesgo. La prevalencia de CAC > 0 unidades Agatston fue de 27%, significativamente más alta en hombres (40%) que en mujeres (13%). Los valores medios del puntaje de CAC aumentaron consistentemente con la edad y fueron más altos en hombres que en mujeres en todos los grupos etarios. La edad y el c-LDL elevado se asociaron de manera independiente con la prevalencia de CAC > 0 en hombres y mujeres, mientras que la presión arterial sistólica en las mujeres, y el incremento de la edad en ambos géneros mostró una asociación independiente con la severidad de CAC. Conclusiones: En población mexicana la prevalencia y la extensión de CAC fueron mucho más altas en hombres que en mujeres y aumentaron consistentemente con la edad. Los predictores independientes de la prevalencia de CAC fueron la edad y el c-LDL.
Abstract: Objective: The prevalence of coronary artery calcification (CAC), a specific marker of atherosclerosis, is unknown in Mexico. Our aim was to investigate the prevalence and quantity of CAC and their association with cardiovascular risk factors in a Mexican population. Methods: CAC was measured by multidetector computed tomography in asymptomatic subjects who participated in the Genetics of Atherosclerotic Disease study. Cardiovascular risk factors and medication were recorded. Results: The sample included 1,423 individuals (49.5% men), aged 53.7 ± 8.4 years. Those with CAC showed a higher prevalence of dyslipidaemia, diabetes, hypertension, and other risk factors. The prevalence of CAC > 0 Agatston units was significantly higher among men (40%) than among women (13%). Mean values of CAC score increased consistently with increasing age and were higher in men than women in each age group. Age and high low density lipoprotein cholesterol were independently associated with prevalence of CAC > 0 in men and women, while increasing systolic blood pressure in women and age in both genders showed an independent association with CAC extension. Conclusions: In the Mexican population the prevalence and extent of CAC were much higher in men than in women, and strongly increased with age. Independent predictors of CAC prevalence were age and low density lipoprotein cholesterol (LDL-C).
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Coronary Artery Disease/epidemiology , Vascular Calcification/epidemiology , Coronary Artery Disease/etiology , Cardiovascular Diseases/complications , Prevalence , Cross-Sectional Studies , Risk Factors , Asymptomatic Diseases , Vascular Calcification/etiology , Mexico/epidemiologyABSTRACT
OBJECTIVE: To investigate the high density lipoprotein (HDL) subclasses distribution and chemical composition, as well as low density lipoprotein (LDL) size and LDL oxidation, in coronary male patients treated with statins, that had LDL-cholesterol levels at target (< 100 mg/dL), but whose HDL-cholesterol (< 40 mg/dL) and triglycerides (TG > or = 150 mg/dL) levels were abnormal. The control group was formed by statin treated coronary male patients with LDL-C below 100 mg/dL and normal HDL-C and TG levels. MATERIAL AND METHODS: HDL subclasses and LDL size were determined by gradient gel electrophoresis. LDL susceptibility to oxidation was determined by measuring lag phase duration, after adding the oxidant agent. RESULTS: Compared with the control group (n = 35), patients with low HDL-C + high TG (n = 34) showed significantly lower proportions of large HDL and higher proportions of small HDL particles. In addition, these patients had abnormal HDL composition, smaller LDL size, and higher LDL susceptibility to oxidation (p < 0.05 for all). CONCLUSIONS: Coronary patients with optimal LDL-C levels on statin therapy but with low HDL-C and high TG, have HDL and LDL abnormalities that have been shown to be associated with a higher risk of new coronary events.