Cardiovascular
Thyroid peroxidase antibodies are associated with incidence, but not progression, of coronary artery calcification: ELSA-Brasil study Vandrize Meneghini* Vandrize Meneghini William R. Tebar Giuliano Generoso Carolina CPS Janovsky Paulo A. Lotufo Márcio S. Bittencourt Alexandre C. Pereira Isabela M. Benseñor
Introduction: Coronary artery calcification (CAC) is an established risk factor for cardiovascular diseases and early mortality. Recent studies have shown the thyroid peroxidase antibodies (TPOAb) as a marker of chronic low-grade inflammation. Still, little is known regarding the impact of TPOAb levels on CAC incidence and progression.
Objective: We explore the association of TPOAb levels with CAC incidence and progression in an ethnically diverse cohort.
Methods: We included individuals with no prior cardiovascular disease and two CAC measurements in ELSA-Brasil. Fasting plasma TPOAb levels were used as continuous data (log-transformed), categorized in quartiles and as positive TPOAb. We defined incident CAC as a baseline CAC=0 followed by CAC>0 on the second visit. CAC progression was defined according to Berry and Hokanson methods. We performed Cox and logistic regression models to investigate the association of TPOAb levels with CAC incidence and progression, respectively.
Results: A total of 3015 individuals (57.2% women, 49.3±8.1 years, 55.2% white) were included. The mean interscan period was 5.0 ± 1.0 years. CAC incidence occurred in 333 (14.5%) of 2292 individuals with baseline CAC of 0. Among the 723 participants with CAC > 0 at baseline, 328 (45.4%) and 434 (60%) had progression of CAC according to Berry and Hokanson criteria. The highest quartile of TPOAb was associated with a higher risk of CAC incidence when compared to the lowest quartile, even after multiple adjustment (HR: 1.53 95%CI: 1.11-2.11). Similar result was observed for euthyroid participants (HR: 1.62 95%CI: 1.11-2.37); which also showed that higher levels of TPOAb, as a continuous variable, were associated with a higher risk of CAC incidence (HR: 1.23 95%CI: 1.05-1.44). There was no significant association between TPOAb titers and CAC progression (p=NS).
Conclusions: We found that higher levels of TPOAb were associated with higher risk of CAC incidence, but did not affect CAC progression.