Coronary artery calcium for the prediction of mortality in young adults <45 years old and elderly adults >75 years old

Rajesh Tota-Maharaj, Michael J. Blaha, John W. McEvoy, Roger S. Blumenthal, Evan D. Muse, Matthew J. Budoff, Leslee J. Shaw, Daniel S. Berman, Jamal S. Rana, John Rumberger, Tracy Callister, Juan Rivera, Arthur Agatston, Khurram Nasir

Research output: Contribution to journalArticle

Abstract

Aims To determine if coronary artery calcium (CAC) scoring is independently predictive of mortality in young adults and in the elderly population and if a young person with high CAC has a higher mortality risk than an older person with less CAC. Methods and resultsWe studied a cohort of 44 052 asymptomatic patients referred for CAC scans for cardiovascular risk stratification. All-cause mortality rates (MRs) were calculated after stratifying by age groups (<45, 45-54, 55-64, 65-74, and ≥75) and CAC score (0, 1-100, 100-400, and >400). Multivariable Cox regression models were constructed to assess the independent value of CAC for predicting all-cause mortality in the <45-and ≥75-year-old age groups. The MR increased in both the <45-and ≥75-year-old age groups with an increasing CAC group. After multivariable adjustment, increasing CAC remained independently predictive of increased mortality compared with CAC = 0 [<45 age group, hazard ratio (95% confidence interval): CAC = 1-100, 2.3 (1.2-4.2); CAC = 100-400, 7.4 (3.3-16.6); CAC > 400, 34.6 (15.5-77.4); ≥75 age group: CAC = 1-100, 7.0 (2.4-20.8); CAC = 100-400, 9.2 (3.2-26.5); CAC > 400, 16.1 (5.8-45.1)]. Persons <45 years old with CAC = 100-400 and CAC > 400 had 2-and 10-fold increased MRs, respectively, compared with persons ≥75 with no CAC. Individuals ≥75 years old with CAC = 0 had a 5.6-year survival rate of 98%, similar to those in other age groups with CAC = 0 (5.6-year survival, 99%).ConclusionThe value of CAC for predicting mortality extends to both elderly patients and those <45 years old. Elderly persons with no CAC have a lower MR than younger persons with high CAC.

Original languageEnglish (US)
Pages (from-to)2955-2962
Number of pages8
JournalEuropean heart journal
Volume33
Issue number23
DOIs
StatePublished - Dec 1 2012

Keywords

  • Ageing
  • Coronary CT
  • Coronary artery calcium
  • Coronary heart disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Tota-Maharaj, R., Blaha, M. J., McEvoy, J. W., Blumenthal, R. S., Muse, E. D., Budoff, M. J., Shaw, L. J., Berman, D. S., Rana, J. S., Rumberger, J., Callister, T., Rivera, J., Agatston, A., & Nasir, K. (2012). Coronary artery calcium for the prediction of mortality in young adults <45 years old and elderly adults >75 years old. European heart journal, 33(23), 2955-2962. https://doi.org/10.1093/eurheartj/ehs230