Olusola A Orimoloye1, Sandeep Banga2, Zeina A Dardari1, S M Iftekhar Uddin1, Matthew J Budoff3, Daniel S Berman4, Alan Rozanski5, Leslee J Shaw6, John A Rumberger7, Khurram Nasir1,8, Michael D Miedema9, Roger S Blumenthal1, Michael J Blaha1, Mohammadhassan Mirbolouk1. 1. Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, Maryland. 2. Department of Medicine, University of Illinois College of Medicine at Peoria, Peoria, Illinois. 3. Department of Medicine, Harbor-UCLA Medical Center. 4. Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, California. 5. Division of Cardiology, Mount Sinai St. Luke's Hospital. 6. Division of Radiology, Weill Cornell Medical College, New York City, New York. 7. Princeton Longevity Center, Princeton, New Jersey. 8. Yale School of Medicine, New Haven, Connecticut. 9. Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA.
Abstract
BACKGROUND: Coronary artery calcium (CAC) has been shown in multiple populations to predict atherosclerotic cardiovascular disease. However, its predictive value in Asian-Americans is poorly described. PATIENTS AND METHODS: We studied 1621 asymptomatic Asian-Americans in the CAC Consortium, a large multicenter retrospective cohort. CAC was modeled in categorical (CAC = 0; CAC = 1-99; CAC = 100-399; CAC ≥ 400) and continuous [ln (CAC + 1)] forms. Participants were followed over a mean follow-up of 12 ± 4 years for coronary heart disease (CHD) death, cardiovascular disease (CVD) death, and all-cause mortality. The predictive value of CAC for individual outcomes was assessed using multivariable-adjusted Cox regression models adjusted for traditional cardiovascular risk factors and reported as hazard ratios (95% confidence interval). RESULTS: The mean (SD) age of the population was 54 (11.2) years and 64% were men. The mean 10-year atherosclerotic cardiovascular disease risk score was 8%. Approximately half had a CAC score of 0, whereas 22.5% had a CAC score of greater than 100. A total of 56 deaths (16 CVD and 8 CHD) were recorded, with no CVD or CHD deaths in the CAC = 0 group. We noted a significantly increased risk of CHD [hazard ratio (HR): 2.6 (1.5-4.3)] and CVD [HR: 2.3 (1.8-2.9)] mortality per unit increase in In (CAC + 1). Compared to those with CAC scores of 0, individuals with CAC scores of at least 400 had over a three-fold increased risk of all-cause mortality [HR: 3.3 (1.3-8.6)]. CONCLUSION: Although Asian-Americans are a relatively low-risk group, CAC strongly predicts CHD, CVD, and all-cause mortality beyond traditional risk factors. These findings may help address existing knowledge gaps in CVD risk prediction in Asian-Americans.
BACKGROUND: Coronary artery calcium (CAC) has been shown in multiple populations to predict atherosclerotic cardiovascular disease. However, its predictive value in Asian-Americans is poorly described. PATIENTS AND METHODS: We studied 1621 asymptomatic Asian-Americans in the CAC Consortium, a large multicenter retrospective cohort. CAC was modeled in categorical (CAC = 0; CAC = 1-99; CAC = 100-399; CAC ≥ 400) and continuous [ln (CAC + 1)] forms. Participants were followed over a mean follow-up of 12 ± 4 years for coronary heart disease (CHD) death, cardiovascular disease (CVD) death, and all-cause mortality. The predictive value of CAC for individual outcomes was assessed using multivariable-adjusted Cox regression models adjusted for traditional cardiovascular risk factors and reported as hazard ratios (95% confidence interval). RESULTS: The mean (SD) age of the population was 54 (11.2) years and 64% were men. The mean 10-year atherosclerotic cardiovascular disease risk score was 8%. Approximately half had a CAC score of 0, whereas 22.5% had a CAC score of greater than 100. A total of 56 deaths (16 CVD and 8 CHD) were recorded, with no CVD or CHD deaths in the CAC = 0 group. We noted a significantly increased risk of CHD [hazard ratio (HR): 2.6 (1.5-4.3)] and CVD [HR: 2.3 (1.8-2.9)] mortality per unit increase in In (CAC + 1). Compared to those with CAC scores of 0, individuals with CAC scores of at least 400 had over a three-fold increased risk of all-cause mortality [HR: 3.3 (1.3-8.6)]. CONCLUSION: Although Asian-Americans are a relatively low-risk group, CAC strongly predicts CHD, CVD, and all-cause mortality beyond traditional risk factors. These findings may help address existing knowledge gaps in CVD risk prediction in Asian-Americans.
Authors: Jaideep Patel; Mahmoud Al Rifai; Miguel Cainzos-Achirica; Namratha R Kandula; Alka M Kanaya; Amit Khera; Roger S Blumenthal; Khurram Nasir; Michael J Blaha; Parag H Joshi Journal: JACC Cardiovasc Imaging Date: 2017-08
Authors: Khurram Nasir; Leslee J Shaw; Sandy T Liu; Steven R Weinstein; Tristen R Mosler; Phillip R Flores; Ferdinand R Flores; Paolo Raggi; Daniel S Berman; Roger S Blumenthal; Matthew J Budoff Journal: J Am Coll Cardiol Date: 2007-08-20 Impact factor: 24.094
Authors: Jaideep Patel; Michael J Blaha; John W McEvoy; Sadia Qadir; Rajesh Tota-Maharaj; Leslee J Shaw; John A Rumberger; Tracy Q Callister; Daniel S Berman; James K Min; Paolo Raggi; Arthur A Agatston; Roger S Blumenthal; Matthew J Budoff; Khurram Nasir Journal: J Cardiovasc Comput Tomogr Date: 2014-01-08
Authors: Robert Detrano; Alan D Guerci; J Jeffrey Carr; Diane E Bild; Gregory Burke; Aaron R Folsom; Kiang Liu; Steven Shea; Moyses Szklo; David A Bluemke; Daniel H O'Leary; Russell Tracy; Karol Watson; Nathan D Wong; Richard A Kronmal Journal: N Engl J Med Date: 2008-03-27 Impact factor: 91.245
Authors: Song S Mao; Raveen S Pal; Charles R McKay; Yan G Gao; Ambarish Gopal; Naser Ahmadi; Janis Child; Sivi Carson; Junichiro Takasu; Behnaz Sarlak; Daniel Bechmann; Matthew Jay Budoff Journal: J Comput Assist Tomogr Date: 2009 Mar-Apr Impact factor: 1.826
Authors: Khurram Nasir; Marcio S Bittencourt; Michael J Blaha; Ron Blankstein; Arthur S Agatson; Juan J Rivera; Michael D Miedema; Michael D Miemdema; Christopher T Sibley; Leslee J Shaw; Roger S Blumenthal; Matthew J Budoff; Harlan M Krumholz Journal: J Am Coll Cardiol Date: 2015-10-13 Impact factor: 24.094
Authors: Matthew J Budoff; Rebekah Young; Gregory Burke; J Jeffrey Carr; Robert C Detrano; Aaron R Folsom; Richard Kronmal; Joao A C Lima; Kiang J Liu; Robyn L McClelland; Erin Michos; Wendy S Post; Steven Shea; Karol E Watson; Nathan D Wong Journal: Eur Heart J Date: 2018-07-01 Impact factor: 35.855
Authors: Siegfried Adelhoefer; S M Iftekhar Uddin; Albert D Osei; Olufunmilayo H Obisesan; Michael J Blaha; Omar Dzaye Journal: Radiol Cardiothorac Imaging Date: 2020-12-17
Authors: Olufunmilayo H Obisesan; Albert D Osei; Daniel Berman; Zeina A Dardari; S M Iftekhar Uddin; Omar Dzaye; Olusola A Orimoloye; Matthew J Budoff; Michael D Miedema; John Rumberger; Mohammadhassan Mirbolouk; Ellen Boakye; Michelle C Johansen; Alan Rozanski; Leslee J Shaw; Donghee Han; Khurram Nasir; Michael J Blaha Journal: Am J Cardiol Date: 2021-03-03 Impact factor: 3.133
Authors: Solomon W Bienstock; Rajeev Samtani; Ashton C Lai; Usman Baber; Dylan Sperling; Anton Camaj; Jason Feinman; Peter Ting; Nikola Kocovic; Emily Li; Martin E Goldman Journal: Int J Cardiol Heart Vasc Date: 2021-09-24