Abstract 495: Clinical Outcome of Progression of Coronary Artery Calcification in Asymptomatic Subjects: Impact of Age and Gender
Background: Coronary artery calcification (CAC) is pathognomonic of coronary atherosclerosis. We investigated the impact of age and gender on the clinical outcome of progression of CAC.
Methods: Four thousand and nine asymptomatic subjects (57 ±10 years, 33% female) who underwent baseline and follow-up CAC measurement within 2 years, were prospectively followed for 4 ±2 years. The absolute annual changes in CAC (ΔCAC) in both genders were measured. ΔCAC was defined ΔCAC <25, ΔCAC 25–50, ΔCAC 50 –100 and ΔCAC >100. Multivariable Cox proportional hazard regression analysis models were developed to predict all-cause mortality in both genders.
Results: Age was not different in both genders. Death rate was 4.7%. Men had more ΔCAC than women (43 ±128 vs. 25 ±100, p = 0.0001). Similarly menopausal women had more ΔCAC than premenopausal women (36 ±102 vs. 12 ±92, p = 0.0001). Risk adjusted hazard ratio of death was increased from ΔCAC 25–50 to ΔCAC 50 –100 to ΔCAC >100 as compared to ΔCAC <25 in both genders (HR: 6.7, 10.9, 37.7 in men, and 6.5, 9.9, 33.8 in menopausal women, respectively) (figure⇓). Furthermore, risk adjusted hazard ratio of death in ΔCAC <25, ΔCAC 25–50, ΔCAC 50 –100 and ΔCAC >100 were higher in men than menopausal women (HR: 1.03, 1.31, 1.62 and 1.82, respectively).
Conclusion: Current study demonstrates that CAC progression increased from premenopausal to menopausal and from women to men, and is associated with poor clinical outcome. Furthermore, clinical outcome of CAC progression was worse in men than women with the similar extent of CAC progression.