Risk Factors That Most Accurately Predict Coronary Artery Disease Based on the Duration of Follow-up　― NIPPON DATA80

• Published in: Circulation Journal Vol. 85; no. 6; pp. 908 - 913
• Main Authors: Okami, Yukiko, Ueshima, Hirotsugu, Nakamura, Yasuyuki, Kondo, Keiko, Kadota, Aya, Okuda, Nagako, Ohkubo, Takayoshi, Miyamatsu, Naomi, Okamura, Tomonori, Miura, Katsuyuki, Okayama, Akira, for the NIPPON DATA80 Research Group
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 25.05.2021
• Subjects: Coronary artery disease; Coronary Artery Disease - epidemiology; Female; Follow-Up Studies; Humans; Longitudinal Studies; Male; Proportional Hazards Models; Prospective cohort study; Prospective Studies; Risk factor; Risk Factors; Time change; Time change; Coronary artery disease; Prospective cohort study; Risk factor
• ISSN: 1346-9843; 1347-4820; 1347-4820
• DOI: 10.1253/circj.CJ-20-0739

Background:This study assessed sex-specific time-associated changes in the impact of risk factors on coronary artery disease (CAD) mortality in a general population over long-term follow-up.Methods and Results:A prospective longitudinal cohort study was conducted on representative Japanese populations followed up for 29 years. Data from 8,396 participants (3,745 men, 4,651 women) were analyzed. The sex-specific multivariable adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of 4 risk factors (smoking, diabetes, serum total cholesterol [TC], and systolic blood pressure [SBP]) for CAD mortality were calculated at baseline and at 10, 15, 20, 25, and 29 years of follow-up. In men, smoking (HR 3.23; 95% CI 1.16–9.02) and a 1-SD increase in TC (HR 1.82; 95% CI 1.29–2.57) were strongly associated with a higher risk of CAD in the first 10 years, but this association decreased over time. Diabetes (HR 2.30; 95% CI 1.37–3.85) and a 1-SD increase in SBP (HR 1.23; 95% CI 1.00–1.50) were strongly correlated with a higher risk of CAD after 29 years). In women, diabetes was correlated with CAD after 20 years (HR 2.53; 95% CI 1.19–5.36) and this correlation persisted until after 29 years (HR 2.47; 95% CI 1.40–4.35).Conclusions:The duration of follow-up needed for the accurate assessment of risk factors for CAD mortality varies according to risk factor and sex.