Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Risk Score in Young Adults Predicts Coronary Artery and Abdominal Aorta Calcium in Middle Age: The CARDIA Study
Background—We explored whether, the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) coronary and abdominal risk scores measured at ages 18-30 years and changes in these scores would more strongly predict coronary artery calcium (CAC) and abdominal aortic calcium (AAC) assessed 25 years later, than scores measured 25 years later.
Methods and Results—In the Coronary Artery Risk Development in Young Adults study, 3008 participants had measurements of risk score components at 5 year intervals beginning at ages 18-30 years. CAC and AAC were assessed at age 43-55 years. Odds ratios (OR) for presence and extent of CAC/AAC per/point higher score and c-statistics for predicting CAC/AAC were calculated. Prevalence of CAC was 28% and AAC was 53%. For each one point higher PDAY score, odds of CAC were higher using baseline scores than year 25 scores (OR 1.29 [95% CI 1.25-1.33] vs 1.12 [1.11-1.14]). For AAC, ORs at years 0 and 25 were similar (1.29 [1.24-1.34] vs 1.22 [1.19 -1.26]). C-statistic for CAC prediction was higher at year 0 than year 25 (0.731 vs 0.705) but similar at years 0 and 25 for AAC (0.665 vs 0.670). ORs for CAC were highest at baseline, and for AAC, year 10. Including change in PDAY scores with baseline scores improved prediction.
Conclusions—Atherosclerosis risk and change in risk assessed in young adulthood years prior to subclinical atherosclerosis imaging provide strong prediction of future subclinical atherosclerosis. CAC and AAC reflect chronic risk exposure in addition to risk measured at time of study.
- Received June 17, 2015.
- Revision received September 21, 2015.
- Accepted October 23, 2015.