Distribution and burden of newly detected coronary artery calcium: Results from the Multi-Ethnic Study of Atherosclerosis

Krishna Alluri, John W. McEvoy, Zeina A. Dardari, Steven Jones, Khurram Nasir, Ron Blankstein, Juan J. Rivera, Arthur A. Agatston, Joel D. Kaufman, Matthew J. Budoff, Roger S Blumenthal, Michael Blaha

Research output: Contribution to journalArticle

Abstract

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 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.

Original languageEnglish (US)
Pages (from-to)337-344.e1
JournalJournal of Cardiovascular Computed Tomography
Volume9
Issue number4
DOIs
StatePublished - Jul 1 2015

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Atherosclerosis
Coronary Vessels
Calcium
Arteries
Hispanic Americans
African Americans
Obesity
Logistic Models
Hypertension

Keywords

  • Coronary artery calcium
  • Left anterior descending artery
  • Left circumflex artery
  • Left main artery
  • Right coronary artery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Distribution and burden of newly detected coronary artery calcium : Results from the Multi-Ethnic Study of Atherosclerosis. / Alluri, Krishna; McEvoy, John W.; Dardari, Zeina A.; Jones, Steven; Nasir, Khurram; Blankstein, Ron; Rivera, Juan J.; Agatston, Arthur A.; Kaufman, Joel D.; Budoff, Matthew J.; Blumenthal, Roger S; Blaha, Michael.

In: Journal of Cardiovascular Computed Tomography, Vol. 9, No. 4, 01.07.2015, p. 337-344.e1.

Research output: Contribution to journalArticle

Alluri, Krishna ; McEvoy, John W. ; Dardari, Zeina A. ; Jones, Steven ; Nasir, Khurram ; Blankstein, Ron ; Rivera, Juan J. ; Agatston, Arthur A. ; Kaufman, Joel D. ; Budoff, Matthew J. ; Blumenthal, Roger S ; Blaha, Michael. / Distribution and burden of newly detected coronary artery calcium : Results from the Multi-Ethnic Study of Atherosclerosis. In: Journal of Cardiovascular Computed Tomography. 2015 ; Vol. 9, No. 4. pp. 337-344.e1.
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abstract = "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 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.",
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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

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

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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 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 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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