Vagal impairment and cardiovascular risk in those with zero to low coronary artery calcification scores: the Multi-Ethnic Study of Atherosclerosis

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Abstract
This study is the first to show that cardiac parasympathetic function, assessed via heart rate fragmentation (HRF), is independently associated with major adverse cardiovascular events (MACEs) in individuals traditionally considered low-risk due to nondetectable or minimal coronary artery calcification (CAC). HRF outperforms both the Framingham and MESA-CAC risk scores in the lowest-risk subgroup over the short term (<10 yr).
Funding Information
  • HHS | NIH | National Heart, Lung, and Blood Institute (R01HL144510)
  • HHS | NIH | National Institute of Biomedical Imaging and Bioengineering (R01EB030362)
  • ICL | National Heart and Lung Institute (R01HL098433)
  • HHS | NIH | National Heart, Lung, and Blood Institute (75N92020D00001)
  • HHS | NIH | National Heart, Lung, and Blood Institute (HHSN268201500003I)
  • HHS | NIH | National Heart, Lung, and Blood Institute (N01-HC-95159)
  • HHS | NIH | National Heart, Lung, and Blood Institute (75N92020D00005)
  • HHS | NIH | National Heart, Lung, and Blood Institute (N01-HC-95160)
  • HHS | NIH | National Heart, Lung, and Blood Institute (75N92020D00002)
  • HHS | NIH | National Heart, Lung, and Blood Institute (N01-HC-95161)
  • HHS | NIH | National Heart, Lung, and Blood Institute (75N92020D00003)
  • HHS | NIH | National Heart, Lung, and Blood Institute (N01-HC-95162)
  • HHS | NIH | National Heart, Lung, and Blood Institute (75N92020D00006)
  • HHS | NIH | National Heart, Lung, and Blood Institute (N01-HC-95163)
  • HHS | NIH | National Heart, Lung, and Blood Institute (75N92020D00004)
  • HHS | NIH | National Heart, Lung, and Blood Institute (N01-HC-95164)
  • HHS | NIH | National Heart, Lung, and Blood Institute (75N92020D00007)
  • HHS | NIH | National Heart, Lung, and Blood Institute (N01-HC-95165)
  • HHS | NIH | National Heart, Lung, and Blood Institute (N01-HC-95166)
  • HHS | NIH | National Heart, Lung, and Blood Institute (N01-HC-95167)
  • HHS | NIH | National Heart, Lung, and Blood Institute (N01-HC-95168)
  • HHS | NIH | National Heart, Lung, and Blood Institute (N01-HC-95169)
  • HHS | NIH | National Center for Advancing Translational Sciences (UL1-TR-000040)
  • HHS | NIH | National Center for Advancing Translational Sciences (UL1-TR-001079)
  • HHS | NIH | National Center for Advancing Translational Sciences (UL1-TR-001420)
  • U.S. Environmental Protection Agency (RD831697)
  • U.S. Environmental Protection Agency (RD-83830001)
  • HHS | NIH | National Heart, Lung, and Blood Institute (R01AG070867)

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