Progression of Coronary Calcium and Incident Coronary Heart Disease Events
Open accessAbstract
Objectives The study examined whether progression of coronary artery calcium (CAC) is a predictor of future coronary heart disease (CHD) events.Background CAC predicts CHD events and serial measurement of CAC has been proposed to evaluate atherosclerosis progression.Methods We studied 6,778 persons (52.8% female) aged 45 to 84 years from the MESA (Multi-Ethnic Study of Atherosclerosis) study. A total of 5,682 persons had baseline and follow-up CAC scans approximately 2.5 ± 0.8 years apart; multiple imputation was used to account for the remainder (n = 1,096) missing follow-up scans. Median follow-up duration from the baseline was 7.6 (max = 9.0) years. CAC change was assessed by absolute change between baseline and follow-up CAC. Cox proportional hazards regression providing hazard ratios (HRs) examined the relation of change in CAC with CHD events, adjusting for age, gender, ethnicity, baseline calcium score, and other risk factors.Results A total of 343 and 206 hard CHD events occurred. The annual change in CAC averaged 24.9 ± 65.3 Agatston units. Among persons without CAC at baseline (n = 3,396), a 5-unit annual change in CAC was associated with an adjusted HR (95% Confidence Interval) of 1.4 (1.0 to 1.9) for total and 1.5 (1.1 to 2.1) for hard CHD. Among those with CAC >0 at baseline, HRs (per 100 unit annual change) were 1.2 (1.1 to 1.4) and 1.3 (1.1 to 1.5), respectively. Among participants with baseline CAC, those with annual progression of ≥300 units had adjusted HRs of 3.8 (1.5 to 9.6) for total and 6.3 (1.9 to 21.5) for hard CHD compared to those without progression.Conclusions Progression of CAC is associated with an increased risk for future hard and total CHD events.
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Dyslipidemia leads to cardiovascular events by atherosclerotic plaque development and progression.
“Dyslipidemia leads to CV events by atherosclerotic plaque development and progression (5,6).”
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- Authors
- Budoff, M. J., Young, R., Lopez, V. A., Kronmal, R. A., Nasir, K., Blumenthal, R. S., Detrano, R. C., Bild, D. E., Guerci, A. D., Liu, K., Shea, S., Szklo, M., Post, W., Lima, J., Bertoni, A., & Wong, N. D.
- Affiliations
- University of California, Los Angeles (US)
- University of Washington (US)
- Baptist Hospital of Miami (US)
- Johns Hopkins University (US)
- University of California, Irvine (US)
- National Heart, Lung, and Blood Institute (US)
- St. Francis Hospital (US)
- Northwestern University (US)
- Columbia University (US)
- Wake Forest University (US)
- Corresponding author
- Wong, Nathan D.
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2013-03
- Volume
- 61
- Issue
- 12
- Pages
- 1231-1239
- ISSN
- 0735-1097 (ISSN-L)
- PMC
- PMC4148074
- OpenAlex
- W2129783757
- Cited by
- 422
- References
- 38
- Citations by year
- 2026: 33 · 2025: 27 · 2024: 18 · 2023: 23 · 2022: 35 · 2021: 35 · 2020: 43 · 2019: 39 · 2018: 36 · 2017: 28 · 2016: 35 · 2015: 34 · 2014: 25 · 2013: 8 · 2012: 1
- FWCI
- 26.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (n01hc95164-17-0-1, n01hc95165-34-0-1, n01hc95161-24-0-1, n01hc095169-003, n01hc95166-21-0-1, n01hc95162-31-0-1, n01hc95168-27-0-1, n01hc95160-18-0-1, n01hc095167-000, n01hc95163-22-0-1, n01hc95159-40-0-1)
- National Heart, Lung, and Blood Institute (N01 HC-95159, N01-HC-95160, N01-HC095169, R01HL071739, N01 HC-95168, N01 HC95167, (N01-HC-95163, N01 HC-95161, N01 HC95165, N01HC95164, N01-HC-095159, N01-HC, N01-HC-095162, N01‐HC‐95166, N01 HC-95162, HC95159, N01 HC95169)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Keywords
- coronary artery calcium, atherosclerosis progression, incident cardiovascular events, Agatston units, cardiovascular risk prediction, Multi-Ethnic Study of Atherosclerosis
- MeSH terms
- Aged, Aged, 80 and over, Asian, Black or African American, Calcinosis, Coronary Artery Disease, Cross-Cultural Comparison, Ethnicity, Female, Follow-Up Studies, Hispanic or Latino, Humans, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Risk Factors, Tomography, X-Ray Computed, United States, Cohort Studies, Incidence, Disease Progression, White People, Multidetector Computed Tomography
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