Abstract 12288: The Association of Coronary Artery Calcium With Age-related Non-Cardiovascular Disease: The Importance of “Biologic Aging” From the Multi-Ethnic Study of Atherosclerosis (mesa)
Coronary artery calcium (CAC) can be thought of as a measure of biologic vascular aging, associated with increased risk of cardiovascular and all-cause mortality. We sought to determine if CAC is also associated with non-cardiovascular disease (CVD) events. We included 6,814 participants from MESA, aged 45-84 years, free of CVD and cancer at baseline, followed for a median of 8.5 years. We calculated multivariable-adjusted hazard ratios for new hospital ICD-9 diagnoses of cancer, pneumonia, chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD), deep vein thrombosis (DVT) or pulmonary embolism (PE), hip fracture and dementia. Analyses were adjusted for age, gender, race, socioeconomic status, BMI, physical activity, diet, tobacco use, number of medications used, systolic and diastolic blood pressure, total and HDL cholesterol, antihypertensive, aspirin and cholesterol medication use and diabetes. Participants with no CAC had absolute event rates of 6.7% for cancer, 3.2% for CKD, 2.8% for pneumonia, 1.2% for COPD, 1.1% for DVT/PE, 0.6% for dementia and 0.3% for hip fracture. Those with CAC >400 had rates of 20.4%, 13.3, 10.6%, 5.6%, 2.1%, 4.4% and 1.8%, respectively. In multivariable adjusted models comparing those with CAC>400 to the reference group of CAC=0, there was an increased risk of incident cancer (HR 1.87, 95% CI 1.43-2.43), CKD (2.31, 1.62 [[Unable to Display Character: –]] 3.29), pneumonia (2.41, 1.64-3.54), COPD (3.59, 2.07-6.22), dementia (2.26; 1.15 [[Unable to Display Character: –]] 4.45) and hip fracture (3.31, 1.17-9.36). There was no association with DVT/PE (HR 0.95, 0.44 [[Unable to Display Character: –]] 2.07). In conclusion, markedly elevated CAC scores are associated with increased risk of a number of age-related diseases, while participants with no CAC are at very low risk of the same non-CVD outcomes. CAC measurement may identify those at overall low and high-risk for multiple chronic diseases, with implications for disease-specific early preventive interventions, and for assessing future use of health care resources.
Author Disclosures: C.E. Handy: None. C.S. Desai: None. Z. Dardari: None. M.H. Al-Mallah: None. M. Miedema: None. P. Ouyang: None. M.J. Budoff: None. R.S. Blumenthal: None. K. Nasir: None. M.J. Blaha: None.
- © 2014 by American Heart Association, Inc.