TY - JOUR
T1 - Distribution and burden of newly detected coronary artery calcium
T2 - Results from the Multi-Ethnic Study of Atherosclerosis
AU - Alluri, Krishna
AU - McEvoy, John W.
AU - Dardari, Zeina A.
AU - Jones, Steven R.
AU - Nasir, Khurram
AU - Blankstein, Ron
AU - Rivera, Juan J.
AU - Agatston, Arthur A.
AU - Kaufman, Joel D.
AU - Budoff, Matthew J.
AU - Blumenthal, Roger S.
AU - Blaha, Michael J.
N1 - Publisher Copyright:
© 2015 Society of Cardiovascular Computed Tomography.
PY - 2015/7/1
Y1 - 2015/7/1
N2 - Background: The transition from no coronary artery calcium (CAC) to detectable CAC is important, as even mild CAC is associated with increased cardiovascular events. We sought to characterize the anatomic distribution and burden of newly detectable CAC over 10-year follow-up. Methods: We evaluated 3112 participants (mean age, 58 years; 64% female) with baseline CAC = 0 from the Multi-Ethnic Study of Atherosclerosis. Participants underwent repeat CAC testing at different time intervals (between 2-10 years after baseline) per the Multi-Ethnic Study of Atherosclerosis protocol. Among participants who developed CAC on a follow-up scan, we used logistic regression and marginal probability modeling to describe the coronary distribution and burden of new CAC by age, sex, and race after adjustment for cardiovascular risk factors and time to detection. Results: A total of 1125 participants developed detectable CAC during follow-up with a mean time to detection of 6.1 ± 3 years. New CAC was most commonly isolated to 1 vessel (72% of participants), with the left anterior descending artery (44% of total) most commonly affected followed by the right coronary (12%), left circumflex (10%), and left main (6%). These patterns were similar across age, sex, and race. In multivariate models, residual predictors of multivessel CAC (28% of total) included male sex, African American or Hispanic race, hypertension, obesity, and diabetes. At the first detection of CAC >0, burden was usually low with median Agatston CAC score of 7.1 and <5% with CAC scores >100. Conclusion: New-onset CAC most commonly involves just 1 vessel, occurs in the left anterior descending artery, and has low CAC burden. New CAC can be detected at an early stage when aggressive preventive strategies may provide benefit.
AB - Background: The transition from no coronary artery calcium (CAC) to detectable CAC is important, as even mild CAC is associated with increased cardiovascular events. We sought to characterize the anatomic distribution and burden of newly detectable CAC over 10-year follow-up. Methods: We evaluated 3112 participants (mean age, 58 years; 64% female) with baseline CAC = 0 from the Multi-Ethnic Study of Atherosclerosis. Participants underwent repeat CAC testing at different time intervals (between 2-10 years after baseline) per the Multi-Ethnic Study of Atherosclerosis protocol. Among participants who developed CAC on a follow-up scan, we used logistic regression and marginal probability modeling to describe the coronary distribution and burden of new CAC by age, sex, and race after adjustment for cardiovascular risk factors and time to detection. Results: A total of 1125 participants developed detectable CAC during follow-up with a mean time to detection of 6.1 ± 3 years. New CAC was most commonly isolated to 1 vessel (72% of participants), with the left anterior descending artery (44% of total) most commonly affected followed by the right coronary (12%), left circumflex (10%), and left main (6%). These patterns were similar across age, sex, and race. In multivariate models, residual predictors of multivessel CAC (28% of total) included male sex, African American or Hispanic race, hypertension, obesity, and diabetes. At the first detection of CAC >0, burden was usually low with median Agatston CAC score of 7.1 and <5% with CAC scores >100. Conclusion: New-onset CAC most commonly involves just 1 vessel, occurs in the left anterior descending artery, and has low CAC burden. New CAC can be detected at an early stage when aggressive preventive strategies may provide benefit.
KW - Coronary artery calcium
KW - Left anterior descending artery
KW - Left circumflex artery
KW - Left main artery
KW - Right coronary artery
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U2 - 10.1016/j.jcct.2015.03.015
DO - 10.1016/j.jcct.2015.03.015
M3 - Article
C2 - 26088381
AN - SCOPUS:84930902326
SN - 1934-5925
VL - 9
SP - 337-344.e1
JO - Journal of cardiovascular computed tomography
JF - Journal of cardiovascular computed tomography
IS - 4
ER -