Multiethnic Study of Breast Arterial Calcium Gradation and CVD

乳腺动脉钙分级和 CVD 的多种族研究

基本信息

批准号：
8330761
负责人：
Carlos Iribarren
金额：
$ 217.96万
依托单位：
KAISER FOUNDATION RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-09-12 至 2016-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8330761
关键词：
Advisory Committees African American Age Alcohol consumption Anger Ankle Asians Atherosclerosis Body mass index Brain hemorrhage Breast Breast Cancer Early Detection Breast Feeding C-reactive protein Calcium California Cardiovascular Diseases Cardiovascular system Caucasians Caucasoid Race Cause of Death Cerebrovascular Disorders Classification Clinical Clinical Practice Guideline Coronary heart disease Data Densitometry Detection Diabetes Mellitus Diet Ethnic Origin Event Family history of Female Future Glomerular Filtration Rate Heart Diseases Heart failure High Density Lipoprotein Cholesterol High Prevalence Hispanics Hormones Hostility Household Hyperlipidemia Hypertension Incidental Findings Income Insulin Resistance Ischemic Stroke Latina Malignant Neoplasms Mammography Measures Medical center Menopause Metabolism Methods Minerals Nitrogen Obstructive Sleep Apnea Parathyroid gland Participant Peripheral Vascular Diseases Pharmaceutical Preparations Phosphorus Physical activity Preventive Prospective Studies Psychosocial Factor Race Recording of previous events Recruitment Activity Reliance Renal function Reproductive Health Research Risk Risk Factors Role Screening procedure Serum Services Severities Sleep Smoking Social support Stratification Testing Therapeutic Intervention Time Transient Ischemic Attack Variant Vitamin D Woman aged base bisphosphonate calcification cardiovascular disorder risk cardiovascular risk factor cohort coronary artery calcification depressive symptoms digital hormone therapy improved indexing insight malignant breast neoplasm milligram novel parity population based tool vascular bed waist circumference

项目摘要

DESCRIPTION (provided by applicant): Currently, mammographically-detected breast arterial calcifications (BAC) are considered an incidental finding without clinical importance since they are not associated with increased risk of breast cancer. However, presence of BAC on mammography correlates with several (but not all) traditional cardiovascular disease (CVD) risk factors and with prevalent and incident CVD. Thus, BAC detected during routine mammography is a noteworthy finding that could be valuable in identifying asymptomatic women at increased future CVD risk that may be candidates for more aggressive management. In addition, there are notable differences in measures of subclinical atherosclerosis burden in women (i.e., coronary artery calcification) by race/ethnic background, and the same appears to be true for BAC, although data are very limited. Another noteworthy limitation of prior research on BAC is the reliance on absence vs. presence of BAC; no study to date has determined gradation of BAC. The 3 specific aims are: 1) To establish a multi- ethnic cohort (n=5,400) between the ages of 60 and 79 years with equal representation of white (n=1,350; 25%), African-American (n=1,350; 25%), Asian (n=1,350; 25%) and Hispanic/Latina (n=1,350; 25%) women. All participants will be recruited at the time of their regular screening mammography (over a 2 year period) at three Kaiser Permanente of Northern California medical centers and will be free of clinical CVD at baseline. A new, validated densitometry method will be used to estimate BAC mass (in milligrams) using digital mammograms; 2) To document race/ethnic variation in BAC mass and to examine associations of BAC mass with sociodemographic background, family history of CVD, traditional and novel CVD risk factors, reproductive health factors, psychosocial factors, selected mineral metabolism factors, selected medication use (statins and nitrogen-containing bisphosphonates), breast size and sleep-related factors; and 3) To elucidate the role of BAC mass in the prediction of coronary heart disease (CHD), cerebrovascular disease, heart failure, peripheral vascular disease and total CVD and to determine whether adding BAC mass to predictionmodels based on traditional risk factors improves classification of risk for total CVD and its components. Accomplishing these aims will provide novel insights into the utility of BAC mass as a screening tool to assess CVD risk.

描述（由申请人提供）：目前，乳房X光检查检测到的乳腺动脉钙化（BAC）被认为是偶然发现，没有临床意义，因为它们与乳腺癌风险增加无关。然而，乳房 X 光检查中 BAC 的存在与多种（但不是全部）传统心血管疾病 (CVD) 危险因素以及流行和偶发的 CVD 相关。因此，在常规乳房 X 光检查中检测到的 BAC 是一个值得注意的发现，对于识别未来 CVD 风险增加的无症状女性可能很有价值，这些女性可能是更积极治疗的候选者。此外，不同种族/民族背景的女性亚临床动脉粥样硬化负担（即冠状动脉钙化）指标存在显着差异，BAC 似乎也是如此，尽管数据非常有限。先前 BAC 研究的另一个值得注意的局限性是依赖于 BAC 的缺失与存在；迄今为止，尚无研究确定 BAC 的分级。这 3 个具体目标是： 1) 建立一个年龄在 60 岁至 79 岁之间的多种族队列（n=5,400），其中白人（n=1,350；25%）、非裔美国人（n=1,350；25%）、非裔美国人（n=1,350）和非裔美国人（n=1,350）具有同等代表性。 25%）、亚裔（n=1,350；25%）和西班牙裔/拉丁裔（n=1,350；25%）女性。所有参与者都将在北加州三个 Kaiser Permanente 医疗中心进行定期乳房 X 光检查（超过 2 年）时被招募，并且在基线时没有临床 CVD。一种新的、经过验证的密度测定方法将用于通过数字乳房 X 光检查来估计 BAC 质量（以毫克为单位）； 2) 记录 BAC 质量的种族/民族差异，并检查 BAC 质量与社会人口背景、CVD 家族史、传统和新的 CVD 危险因素、生殖健康因素、社会心理因素、选定的矿物质代谢因素、选定的药物使用之间的关联（他汀类药物和含氮双膦酸盐）、乳房大小和睡眠相关因素； 3) 阐明 BAC 质量在预测冠心病 (CHD)、脑血管疾病、心力衰竭、周围血管疾病和总 CVD 中的作用，并确定将 BAC 质量添加到基于传统危险因素的预测模型中是否可以改善分类总 CVD 及其组成部分的风险。实现这些目标将为 BAC 质量作为评估 CVD 风险的筛查工具的效用提供新的见解。