scholarly journals Spatially Weighted Coronary Artery Calcium Score and Coronary Heart Disease Events in the Multi-Ethnic Study of Atherosclerosis

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Steven Shea ◽  
Ana Navas-Acien ◽  
Daichi Shimbo ◽  
Elizabeth R. Brown ◽  
Matthew Budoff ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Calcium Score ◽  
Natural Logarithm ◽  
Computed Tomography Scanning ◽  
Tomography Scanning

Background: A limitation of the Agatston coronary artery calcium (CAC) score is that it does not use all of the calcium density information in the computed tomography scan such that many individuals have a score of zero. We examined the predictive validity for incident coronary heart disease (CHD) events of the spatially weighted coronary calcium score (SWCS), an alternative scoring method for CAC that assigns scores to individuals with Agatston CAC=0. Methods: The MESA (Multi-Ethnic Study of Atherosclerosis) is a longitudinal study that conducted a baseline exam from 2000 to 2002 in 6814 participants including computed tomography scanning for CAC. Subsequent exams and systematic follow-up of the cohort for outcomes were performed. Statistical models were adjusted using the MESA risk score based on age, sex, race/ethnicity, systolic blood pressure, use of hypertension medications, diabetes, total and HDL (high-density lipoprotein) cholesterol, use of lipid-lowering medications, smoking status, and family history of heart attack. Results: In the 3286 participants with Agatston CAC=0 at baseline and for whom SWCS was computed, 98 incident CHD events defined as definite or probably myocardial infarction or definite CHD death occurred during a median follow-up of 15.1 years. In this group, SWCS predicted incident CHD events after multivariable adjustment (hazard ratio=1.30 per SD of natural logarithm [SWCS] [95% CI, 1.04–1.60]; P =0.005); and progression from Agatston CAC=0 at baseline to CAC>0 at subsequent exams (multivariable-adjusted incidence rate difference per SD of natural logarithm [SWCS] per 100 person-years 1.68 [95% CI, 1.03–2.33]; P <0.0001). Conclusions: SWCS predicts incident CHD events in individuals with Agatston CAC score=0 as well as conversion to Agatston CAC>0 at repeat computed tomography scanning at later exams. SWCS has predictive validity as a subclinical phenotype and marker of CHD risk in individuals with Agatston CAC=0.

scholarly journals Value of Coronary Artery Calcium Scanning by Computed Tomography for Predicting Coronary Heart Disease in Diabetic Subjects

Diabetes Care ◽  
2003 ◽  
Vol 26 (3) ◽  
pp. 905-910 ◽  
Author(s):  
W. Qu ◽  
T. T. Le ◽  
S. P. Azen ◽  
M. Xiang ◽  
N. D. Wong ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Artery Calcium

scholarly journals Using the Coronary Artery Calcium Score to Predict Coronary Heart Disease Events

2004 ◽  
Vol 164 (12) ◽  
pp. 1285 ◽  
Author(s):  
Mark J. Pletcher ◽  
Jeffrey A. Tice ◽  
Michael Pignone ◽  
Warren S. Browner
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Coronary Artery Calcium Score ◽  
Calcium Score

scholarly journals Long-term Predictions of Incident Coronary Artery Calcium to 85 Years of Age for Asymptomatic Individuals with and without Type 2 Diabetes

2021 ◽  
Author(s):  
Bart S. Ferket ◽  
M.G. Myriam Hunink ◽  
Umesh Masharani ◽  
Wendy Max ◽  
Joseph Yeboah ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Cardiovascular Events ◽  
Diabetes Treatment ◽  
The Impact

<b>Objective</b> <p>To examine the utility of repeated computed tomography (CT) coronary artery calcium (CAC) testing, we assessed risks of detectable CAC and its cardiovascular consequences in individuals with and without type 2 diabetes from ages 45 to 85 years.</p> <p><b>Research Design and Methods</b></p> <p>We included 5836 individuals (618 with type 2 diabetes, 2972 without baseline CAC) from the Multi-Ethnic Study of Atherosclerosis. Logistic and Cox regression evaluated the impact of type 2 diabetes, diabetes treatment duration and other predictors on prevalent and incident CAC. We used time-dependent Cox modeling of follow-up data (median 15.9 years) for two repeat CT exams and cardiovascular events to assess the association of CAC at follow-up CT with cardiovascular events.</p> <p><b>Results</b></p> <p>For 45-year-olds with type 2 diabetes, the likelihood of CAC at baseline was 23% versus 17% for those without. Median age at incident CAC was 52.2 versus 62.3 years for those with and without diabetes. Each 5 years of diabetes treatment increased the odds and hazard rate of CAC by 19% (95% confidence interval [CI] 8-33%) and 22% (95% CI 6-41%). Male gender, white ethnicity/race, hypertension, hypercholesterolemia, obesity, and low serum creatinine also increased CAC. CAC at follow-up CT independently increased coronary heart disease rates. </p> <p><b>Conclusions </b></p> <p>We estimated cumulative CAC incidence to age 85. Patients with type 2 diabetes develop CAC at a younger age than those without diabetes. Because incident CAC is associated with increased coronary heart disease risk, the value of periodic CAC-based risk assessment in type 2 diabetes should be evaluated.</p>

scholarly journals Association of Abdominal Aorta Calcium and Coronary Artery Calcium with Incident Cardiovascular and Coronary Heart Disease Events in Black and White Middle‐Aged People: The Coronary Artery Risk Development in Young Adults Study

2021 ◽  
Author(s):  
Paul T. Jurgens ◽  
John J. Carr ◽  
James G. Terry ◽  
Jamal S. Rana ◽  
David R. Jacobs ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Young Adults ◽  
Heart Disease ◽  
Coronary Artery ◽  
Abdominal Aorta ◽  
Coronary Artery Calcium ◽  
Middle Aged ◽  
Black And White

Background Assessing coronary artery calcium (CAC) is among AHA/ACC prevention guidelines for people at least 40 years old at intermediate risk for coronary heart disease (CHD). To study enhanced risk stratification, we investigated the predictive value of abdominal aorta calcium (AAC) relative to CAC for cardiovascular disease (CVD) and CHD events in Black and White early middle‐aged participants, initially free of overt CVD. Methods and Results In the CARDIA (Coronary Artery Risk Development in Young Adults) study, a multi‐center, community‐based, longitudinal cohort study of CVD risk, the CAC and AAC scores were assessed in 3011 participants in 2010–2011 with follow‐up until 2019 for incident CVD and CHD events. Distributions and predictions, overall and by race, were computed. During the 8‐year follow‐up, 106 incident CVD events (55 were CHD) occurred. AAC scores tended to be much higher than CAC scores. AAC scores were higher in Black women than in White women. CAC predicted CVD with HR 1.77 (1.52–2.06) and similarly for AAC, while only CAC predicted CHD. After adjustment for risk factors and calcium in the other arterial bed, the association of CAC with CVD was independent of risk factors and AAC, while the association of AAC with CVD was greatly attenuated. However, AAC predicted incident CVD when CAC was 0. Prediction did not vary by race. Conclusions AAC predicted CVD nearly as strongly as CAC and could be especially useful as a diagnostic tool when it is an incidental finding or when no CAC is found.

Sign in / Sign up

Export Citation Format

Share Document