BACKGROUND: Coronary artery calcium (CAC) scores predict coronary heart disease (CHD) risk. Little is known, however, about the distinctive risk among asymptomatic individuals with very high CAC (≥ 1000) compared to high CAC (400-999). METHODS AND RESULTS: We compared CHD risk factors and event rates between participants with very high CAC (n = 257) and high CAC (n = 420) among adults free of clinical CHD in the Multi-Ethnic Study of Atherosclerosis (MESA). CAC was measured at baseline, and participants were followed for a median of 68 months. Very high CAC (≥ 1000), compared to high CAC (400-999), was associated with male gender (OR 3.10, p < 0.001) and older age (OR 1.42 per 10 year increase, p < 0.001). Chronic kidney disease (CKD) was associated with very high CAC (OR 1.66, p = 0.009) with a greater prevalence of moderate CKD (GFR 30-59) in the ≥ 1000 group (25% vs. 18%). Those with very high CAC were more likely to develop angina (adjusted HR 1.72 [95% CI 1.03-2.90], p = 0.04), but not more likely to experience myocardial infarction, resuscitated cardiac arrest, or CHD death (adjusted HR 1.17, [95% CI 0.64-2.12] p = 0.61) compared to high CAC. Total CHD event rates were greater for very high CAC (3.7 per 100 person-years) compared to high CAC (2.6 per 100 person-years). CONCLUSIONS: Both high and very high CAC are associated with an elevated risk of CHD events in those without symptomatic CHD at baseline; however, very high CAC is associated with an increased risk of angina, but not CHD death or MI, compared to high CAC.
BACKGROUND: Coronary artery calcium (CAC) scores predict coronary heart disease (CHD) risk. Little is known, however, about the distinctive risk among asymptomatic individuals with very high CAC (≥ 1000) compared to high CAC (400-999). METHODS AND RESULTS: We compared CHD risk factors and event rates between participants with very high CAC (n = 257) and high CAC (n = 420) among adults free of clinical CHD in the Multi-Ethnic Study of Atherosclerosis (MESA). CAC was measured at baseline, and participants were followed for a median of 68 months. Very high CAC (≥ 1000), compared to high CAC (400-999), was associated with male gender (OR 3.10, p < 0.001) and older age (OR 1.42 per 10 year increase, p < 0.001). Chronic kidney disease (CKD) was associated with very high CAC (OR 1.66, p = 0.009) with a greater prevalence of moderate CKD (GFR 30-59) in the ≥ 1000 group (25% vs. 18%). Those with very high CAC were more likely to develop angina (adjusted HR 1.72 [95% CI 1.03-2.90], p = 0.04), but not more likely to experience myocardial infarction, resuscitated cardiac arrest, or CHD death (adjusted HR 1.17, [95% CI 0.64-2.12] p = 0.61) compared to high CAC. Total CHD event rates were greater for very high CAC (3.7 per 100 person-years) compared to high CAC (2.6 per 100 person-years). CONCLUSIONS: Both high and very high CAC are associated with an elevated risk of CHD events in those without symptomatic CHD at baseline; however, very high CAC is associated with an increased risk of angina, but not CHD death or MI, compared to high CAC.
Authors: Jaideep Patel; Mahmoud Al Rifai; Maren T Scheuner; Steven Shea; Roger S Blumenthal; Khurram Nasir; Michael J Blaha; John W McEvoy Journal: Mayo Clin Proc Date: 2018-03-16 Impact factor: 7.616
Authors: Allison W Peng; Zeina A Dardari; Roger S Blumenthal; Omar Dzaye; Olufunmilayo H Obisesan; S M Iftekhar Uddin; Khurram Nasir; Ron Blankstein; Matthew J Budoff; Martin Bødtker Mortensen; Parag H Joshi; John Page; Michael J Blaha Journal: Circulation Date: 2021-03-02 Impact factor: 29.690
Authors: Jane F Ferguson; Gregory J Matthews; Raymond R Townsend; Dominic S Raj; Peter A Kanetsky; Matthew Budoff; Michael J Fischer; Sylvia E Rosas; Radhika Kanthety; Mahboob Rahman; Stephen R Master; Atif Qasim; Mingyao Li; Nehal N Mehta; Haiqing Shen; Braxton D Mitchell; Jeffrey R O'Connell; Alan R Shuldiner; Weang Kee Ho; Robin Young; Asif Rasheed; John Danesh; Jiang He; John W Kusek; Akinlolu O Ojo; John Flack; Alan S Go; Crystal A Gadegbeku; Jackson T Wright; Danish Saleheen; Harold I Feldman; Daniel J Rader; Andrea S Foulkes; Muredach P Reilly Journal: J Am Coll Cardiol Date: 2013-05-30 Impact factor: 24.094