Abstract 494: Age and HDL Cholesterol Predict Progression of Coronary Artery Calcium in Women: Findings From the Women’s Hearts: Ischemic Screening With Proactive Evaluation and Recommendation (WHISPER) Study
Background: Cardiovascular disease affects 1 in 3 females in the U.S. and is the leading cause of death among women. Noninvasive screening using multislice CT (MSCT) for coronary artery calcium (CAC) effectively measures the extent of subclinical atherosclerosis in asymptomatic individuals. We assessed CAC over 2 years in a cohort of women with asymptomatic CAD using MSCT.
Methods: Women age 45– 65 with >3 CAD risk factors but without documented history of CAD were prospectively enrolled after normal findings on SPECT. All subjects underwent comprehensive medical history and multislice or electron beam CT at baseline and 2 years using prospective ECG-triggered sequential and retrospective ECG-gated spiral techniques for image acquisition. CAC scores were assessed using the Agatston method and classified as low (1–100), moderate (101– 400), or high risk (>400).
Results: There were 100 subjects enrolled (mean age 56 years, 72% hypertensive, and 72% with family history of CAD). Compared to patients with improved or unchanged CAC scores at study end, patients with worsened CAC scores were older (improved: 54 years, no change: 54 years vs worsened: 59 years, P <0.001) and had lower HDL cholesterol values (improved: 71 mg/dL, no change: 63 mg/dL vs worsened: 56 mg/dL, P <0.001). After multivariable adjustment, age and HDL cholesterol were independently associated with changes in CAC scores at 2 years (Figure⇓).
Conclusions: In a cohort of women with asymptomatic CAD, age and HDL cholesterol were associated with changes in CAC scores at 2 years. These findings reinforce the importance and impact of lower HDL cholesterol values in women with CAD.