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Coronary artery calcium distributions in older persons in the AGES-Reykjavik study

  • CARDIOVASCULAR DISEASE
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Abstract

Coronary Artery Calcium (CAC) is a sign of advanced atherosclerosis and an independent risk factor for cardiac events. Here, we describe CAC-distributions in an unselected aged population and compare modelling methods to characterize CAC-distribution. CAC is difficult to model because it has a skewed and zero inflated distribution with over-dispersion. Data are from the AGES-Reykjavik sample, a large population based study [2002–2006] in Iceland of 5,764 persons aged 66–96 years. Linear regressions using logarithmic- and Box-Cox transformations on CAC+1, quantile regression and a Zero-Inflated Negative Binomial model (ZINB) were applied. Methods were compared visually and with the PRESS-statistic, R2 and number of detected associations with concurrently measured variables. There were pronounced differences in CAC according to sex, age, history of coronary events and presence of plaque in the carotid artery. Associations with conventional coronary artery disease (CAD) risk factors varied between the sexes. The ZINB model provided the best results with respect to the PRESS-statistic, R2, and predicted proportion of zero scores. The ZINB model detected similar numbers of associations as the linear regression on ln(CAC+1) and usually with the same risk factors.

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Abbreviations

CAC:

Coronary artery calcium

CAD:

Coronary artery disease

CVD:

Cardiovascular disease

CI:

Confidence interval

CIMT:

Carotid intima medial thickness

HDL:

High density lipoprotein

OR:

Odds ratio

SD:

Standard deviation

TIA:

Transient ischemic attack

ZINB:

Zero inflated negative binomial

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Acknowledgments

This work was supported by the National Institutes of Health (NIH) contract N01-AG-12100; the National Institute on Aging, in part by the Intramural Research Program; Hjartavernd (the Icelandic Heart Association); and the Althingi (the Icelandic Parliament).

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Icelandic Heart Association, Research Institute, Holtasmari 1, 201, Kopavogur, Iceland

    Elias Freyr Gudmundsson, Vilmundur Gudnason, Sigurdur Sigurdsson & Thor Aspelund

  2. Faculty of Medicine, University of Iceland, Vatnsmyrarvegi 16, 101, Reykjavik, Iceland

    Vilmundur Gudnason

  3. Laboratory of Epidemiology, Demography, and Biometry, Intramural Research Program, National Institute on Aging, Gateway Building, 3C309 7201 Wisconsin Avenue, Bethesda, MD, 20892, USA

    Lenore J. Launer & Tamara B. Harris

  4. Faculty of Medicine, Public Health, University of Iceland, Stapi Hringbraut, 101, Reykjavik, Iceland

    Thor Aspelund

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  1. Elias Freyr Gudmundsson
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Correspondence to Thor Aspelund.

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Gudmundsson, E.F., Gudnason, V., Sigurdsson, S. et al. Coronary artery calcium distributions in older persons in the AGES-Reykjavik study. Eur J Epidemiol 27, 673–687 (2012). https://doi.org/10.1007/s10654-012-9730-6

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  • DOI: https://doi.org/10.1007/s10654-012-9730-6

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