OBJECTIVES: We sought to study the prognostic utility of coronary artery calcium (CAC) in the elderly. BACKGROUND: The prognostic significance of CAC in the elderly is not well known. METHODS: All-cause mortality was assessed in 35,388 patients (3,570 were >or=70 years old at screening, and 50% were women) after a mean follow-up of 5.8 +/- 3 years. RESULTS: In older patients, risk factors and CAC were more prevalent. Overall survival was 97.9% at the end of follow-up. Mortality increased with each age decile with a relative hazard of 1.09 (95% confidence interval: 1.08 to 1.10, p < 0.0001), and rates were greater for men than women (hazard ratio: 1.53; 95% confidence interval: 1.32 to 1.77, p < 0.0001). Increasing CAC scores were associated with decreasing survival across all age deciles (p < 0.0001). Survival for a <40-year and >or=80-year-old man with a CAC score >or=400 was 88% and 19% (95% and 44% for a woman, p < 0.0001), respectively. Among the 20,562 patients with no CAC, annual mortality rates ranged from 0.3% to 2.2% for patients age 40 to 49 years or >or=70 years (p < 0.0001). The use of CAC allowed us to reclassify more than 40% of the patients >or=70 years old more often by excluding risk (i.e., CAC <400) in those with >3 risk factors. CONCLUSIONS: Despite their limited life expectancy, the use of CAC discriminates mortality risk in the elderly. Furthermore, the use of CAC allows physicians to reclassify risk in the elderly.
OBJECTIVES: We sought to study the prognostic utility of coronary artery calcium (CAC) in the elderly. BACKGROUND: The prognostic significance of CAC in the elderly is not well known. METHODS: All-cause mortality was assessed in 35,388 patients (3,570 were >or=70 years old at screening, and 50% were women) after a mean follow-up of 5.8 +/- 3 years. RESULTS: In older patients, risk factors and CAC were more prevalent. Overall survival was 97.9% at the end of follow-up. Mortality increased with each age decile with a relative hazard of 1.09 (95% confidence interval: 1.08 to 1.10, p < 0.0001), and rates were greater for men than women (hazard ratio: 1.53; 95% confidence interval: 1.32 to 1.77, p < 0.0001). Increasing CAC scores were associated with decreasing survival across all age deciles (p < 0.0001). Survival for a <40-year and >or=80-year-old man with a CAC score >or=400 was 88% and 19% (95% and 44% for a woman, p < 0.0001), respectively. Among the 20,562 patients with no CAC, annual mortality rates ranged from 0.3% to 2.2% for patients age 40 to 49 years or >or=70 years (p < 0.0001). The use of CAC allowed us to reclassify more than 40% of the patients >or=70 years old more often by excluding risk (i.e., CAC <400) in those with >3 risk factors. CONCLUSIONS: Despite their limited life expectancy, the use of CAC discriminates mortality risk in the elderly. Furthermore, the use of CAC allows physicians to reclassify risk in the elderly.
Authors: Jacobo Kirsch; Ivan Buitrago; Tan-Lucien H Mohammed; Tianming Gao; Craig R Asher; Gian M Novaro Journal: Int J Cardiovasc Imaging Date: 2011-08-11 Impact factor: 2.357
Authors: Sana Shah; Naveen Bellam; Jonathon Leipsic; Daniel S Berman; Arshed Quyyumi; Jörg Hausleiter; Stephan Achenbach; Mouaz Al-Mallah; Matthew J Budoff; Fillippo Cademartiri; Tracy Q Callister; Hyuk-Jae Chang; Benjamin J W Chow; Ricardo C Cury; Augustin J Delago; Allison L Dunning; Gudrun M Feuchtner; Martin Hadamitzky; Ronald P Karlsberg; Philipp A Kaufmann; Fay Y Lin; Kavitha M Chinnaiyan; Erica Maffei; Gilbert L Raff; Todd C Villines; Millie J Gomez; James K Min; Leslee J Shaw Journal: J Nucl Cardiol Date: 2014-03-29 Impact factor: 5.952
Authors: Stefan B Puchner; Thomas Mayrhofer; Jakob Park; Michael T Lu; Ting Liu; Pal Maurovich-Horvat; Khristine Ghemigian; Daniel O Bittner; Jerome L Fleg; James E Udelson; Quynh A Truong; Udo Hoffmann; Maros Ferencik Journal: Atherosclerosis Date: 2018-04-17 Impact factor: 5.162
Authors: Qian Xiao; Rachel A Murphy; Denise K Houston; Tamara B Harris; Wong-Ho Chow; Yikyung Park Journal: JAMA Intern Med Date: 2013-04-22 Impact factor: 21.873
Authors: Julie A Lovshin; Petter Bjornstad; Leif E Lovblom; Johnny-Wei Bai; Yuliya Lytvyn; Geneviève Boulet; Mohammed A Farooqi; Sam Santiago; Andrej Orszag; Daniel Scarr; Alanna Weisman; Hillary A Keenan; Michael H Brent; Narinder Paul; Vera Bril; Bruce A Perkins; David Z I Cherney Journal: Diabetes Care Date: 2018-10-01 Impact factor: 19.112