Abstract 12110: Distribution and Burden of New Onset Coronary Artery Calcium (CAC): An Age, Gender, and Race/Ethnicity-Based Analysis From the Multi-Ethnic Study of Atherosclerosis (MESA)
Background: The transition from no coronary artery calcium (CAC) to detectable CAC is important to characterize, as even mild CAC is associated with increased cardiovascular events. We sought to describe the anatomical distribution and burden of newly detectable CAC, as well as their determinants, over 10-year follow-up.
Methods: We evaluated 3112 participants (mean age 58, 64% female) with CAC=0 on baseline cardiac CT imaging from the Multi-Ethnic Study of Atherosclerosis (MESA), a community-based multi-center prospective cohort study. Participants underwent repeat CAC testing at different time intervals (between 2 and 10 years after baseline), as per MESA protocol. Among participants who developed CAC on a follow-up scan, we used logistic regression and marginal probability post-estimation modeling to describe the typical coronary distribution and burden of new CAC by age, gender, and race/ethnicity after adjustment for multiple cardiovascular risk factors and time-to-CAC-detection.
Results: A total of 1125 participants developed newly detected CAC during follow-up, and these people had more cardiovascular risk factors. At the first detection of CAC>0, involvement was most commonly in just one vessel (72%), and the left anterior descending artery (LAD) was the most commonly affected vessel (44%) across all age groups, both genders, and all ethnicities. In multivariable models, residual predictors of multi-vessel new CAC included male gender, African-American and Hispanic race/ethnicity, as well as hypertension, obesity, and diabetes mellitus. At the first detection of CAC>0, the burden was usually low with median Agatston CAC score of 7.1 and 100.
Conclusion: New onset CAC most commonly involves just one vessel, has a low CAC burden, and is most commonly in the LAD. Rescanning for newly detectable CAC may allow detection of focal coronary atherosclerosis at an early stage when aggressive preventive strategies may provide benefit.
Author Disclosures: K. Alluri: None. J. McEvoy: None. S.R. Jones: Research Grant; Modest; Atherotech Diagnostics Lab. Consultant/Advisory Board; Modest; Atherotech Diagnostics Lab, Sanofi - Regeneron. R. Blankstein: None. J.J. Rivera: None. J. Kaufman: None. A. Agatston: None. R.S. Blumenthal: None. M. Budoff: None. K. Nasir: None. M.J. Blaha: None.
- © 2014 by American Heart Association, Inc.