Cross-Sectional Synergistic Risk #8
Description
Using MGI participants, we will perform analyses of major adverse cardiovascular events determining if calcium levels are additive to, or modifying of LDL-C associated cardiovascular risk. We will parameterize calcium both as a linear predictor and then by classifying participants as normocalcemic or hypercalcemic (>12 mg/dL). We will then construct multivariable logistic regression models that include age, BMI, genetic ancestry, neighborhood socioeconomic status, smoking status, and diabetes diagnoses. Similar to our analytical approach above we will first test for sex differences, and depending on those results include sex as a covariate or modifier. In this case we strongly expect sex differences as women experience more rapid bone loss than males. We plan to use a composite endpoint including fatal and nonfatal myocardial infarction, fatal and nonfatal stroke, cardiovascular death, or coronary heart disease death as our primary outcome. Death and cause of death will be validated against the Michigan Death Registry. As a secondary outcome we will evaluate the 3477 patients in this dataset with data from coronary calcium screening.