The Association of Coronary Artery Calcium With Noncardiovascular Disease. The Multi-Ethnic Study of Atherosclerosis

Catherine E. Handy, Chintan S. Desai, Zeina A. Dardari, Mouaz H. Al-Mallah, Michael D. Miedema, Pamela Ouyang, Matthew J. Budoff, Roger S Blumenthal, Khurram Nasir, Michael Blaha

Research output: Contribution to journalArticle

Abstract

Objectives: This study sought to determine if coronary artery calcium (CAC) is associated with incident noncardiovascular disease. Background: CAC is considered a measure of vascular aging, associated with increased risk of cardiovascular and all-cause mortality. The relationship with noncardiovascular disease is not well defined. Methods: A total of 6,814 participants from 6 MESA (Multi-Ethnic Study of Atherosclerosis) field centers were followed for a median of 10.2 years. Modified Cox proportional hazards ratios accounting for the competing risk of fatal coronary heart disease were calculated for new diagnoses of cancer, pneumonia, chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD), deep vein thrombosis/pulmonary embolism, hip fracture, and dementia. Analyses were adjusted for age; sex; race; socioeconomic status; health insurance status; body mass index; physical activity; diet; tobacco use; number of medications used; systolic and diastolic blood pressure; total and high-density lipoprotein cholesterol; antihypertensive, aspirin, and cholesterol medication; and diabetes. The outcome was first incident noncardiovascular disease diagnosis. Results: Compared with those with CAC = 0, those with CAC >400 had an increased hazard of cancer (hazard ratio [HR]: 1.53; 95% confidence interval [CI]: 1.18 to 1.99), CKD (HR: 1.70; 95% CI: 1.21 to 2.39), pneumonia (HR: 1.97; 95% CI: 1.37 to 2.82), COPD (HR: 2.71; 95% CI: 1.60 to 4.57), and hip fracture (HR: 4.29; 95% CI: 1.47 to 12.50). CAC >400 was not associated with dementia or deep vein thrombosis/pulmonary embolism. Those with CAC = 0 had decreased risk of cancer (HR: 0.76; 95% CI: 0.63 to 0.92), CKD (HR: 0.77; 95% CI: 0.60 to 0.98), COPD (HR: 0.61; 95% CI: 0.40 to 0.91), and hip fracture (HR: 0.31; 95% CI: 0.14 to 0.70) compared to those with CAC >0. CAC = 0 was not associated with less pneumonia, dementia, or deep vein thrombosis/pulmonary embolism. The results were attenuated, but remained significant, after removing participants developing interim nonfatal coronary heart disease. Conclusions: Participants with elevated CAC were at increased risk of cancer, CKD, COPD, and hip fractures. Those with CAC = 0 are less likely to develop common age-related comorbid conditions, and represent a unique population of "healthy agers.".

Original languageEnglish (US)
JournalJACC: Cardiovascular Imaging
DOIs
StateAccepted/In press - Aug 4 2015

Fingerprint

Atherosclerosis
Coronary Vessels
Calcium
Confidence Intervals
Hip Fractures
Chronic Renal Insufficiency
Chronic Obstructive Pulmonary Disease
Pulmonary Embolism
Venous Thrombosis
Dementia
Pneumonia
Coronary Disease
Blood Pressure
Neoplasms
Insurance Coverage
Kidney Neoplasms
Tobacco Use
Health Insurance
Social Class
HDL Cholesterol

Keywords

  • Aging
  • Biologic aging
  • Cancer
  • Coronary artery calcium
  • Coronary artery disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

The Association of Coronary Artery Calcium With Noncardiovascular Disease. The Multi-Ethnic Study of Atherosclerosis. / Handy, Catherine E.; Desai, Chintan S.; Dardari, Zeina A.; Al-Mallah, Mouaz H.; Miedema, Michael D.; Ouyang, Pamela; Budoff, Matthew J.; Blumenthal, Roger S; Nasir, Khurram; Blaha, Michael.

In: JACC: Cardiovascular Imaging, 04.08.2015.

Research output: Contribution to journalArticle

@article{99bc4a43f9d64286b6948e750f2b1ed5,
title = "The Association of Coronary Artery Calcium With Noncardiovascular Disease. The Multi-Ethnic Study of Atherosclerosis",
abstract = "Objectives: This study sought to determine if coronary artery calcium (CAC) is associated with incident noncardiovascular disease. Background: CAC is considered a measure of vascular aging, associated with increased risk of cardiovascular and all-cause mortality. The relationship with noncardiovascular disease is not well defined. Methods: A total of 6,814 participants from 6 MESA (Multi-Ethnic Study of Atherosclerosis) field centers were followed for a median of 10.2 years. Modified Cox proportional hazards ratios accounting for the competing risk of fatal coronary heart disease were calculated for new diagnoses of cancer, pneumonia, chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD), deep vein thrombosis/pulmonary embolism, hip fracture, and dementia. Analyses were adjusted for age; sex; race; socioeconomic status; health insurance status; body mass index; physical activity; diet; tobacco use; number of medications used; systolic and diastolic blood pressure; total and high-density lipoprotein cholesterol; antihypertensive, aspirin, and cholesterol medication; and diabetes. The outcome was first incident noncardiovascular disease diagnosis. Results: Compared with those with CAC = 0, those with CAC >400 had an increased hazard of cancer (hazard ratio [HR]: 1.53; 95{\%} confidence interval [CI]: 1.18 to 1.99), CKD (HR: 1.70; 95{\%} CI: 1.21 to 2.39), pneumonia (HR: 1.97; 95{\%} CI: 1.37 to 2.82), COPD (HR: 2.71; 95{\%} CI: 1.60 to 4.57), and hip fracture (HR: 4.29; 95{\%} CI: 1.47 to 12.50). CAC >400 was not associated with dementia or deep vein thrombosis/pulmonary embolism. Those with CAC = 0 had decreased risk of cancer (HR: 0.76; 95{\%} CI: 0.63 to 0.92), CKD (HR: 0.77; 95{\%} CI: 0.60 to 0.98), COPD (HR: 0.61; 95{\%} CI: 0.40 to 0.91), and hip fracture (HR: 0.31; 95{\%} CI: 0.14 to 0.70) compared to those with CAC >0. CAC = 0 was not associated with less pneumonia, dementia, or deep vein thrombosis/pulmonary embolism. The results were attenuated, but remained significant, after removing participants developing interim nonfatal coronary heart disease. Conclusions: Participants with elevated CAC were at increased risk of cancer, CKD, COPD, and hip fractures. Those with CAC = 0 are less likely to develop common age-related comorbid conditions, and represent a unique population of {"}healthy agers.{"}.",
keywords = "Aging, Biologic aging, Cancer, Coronary artery calcium, Coronary artery disease",
author = "Handy, {Catherine E.} and Desai, {Chintan S.} and Dardari, {Zeina A.} and Al-Mallah, {Mouaz H.} and Miedema, {Michael D.} and Pamela Ouyang and Budoff, {Matthew J.} and Blumenthal, {Roger S} and Khurram Nasir and Michael Blaha",
year = "2015",
month = "8",
day = "4",
doi = "10.1016/j.jcmg.2015.09.020",
language = "English (US)",
journal = "JACC: Cardiovascular Imaging",
issn = "1936-878X",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - The Association of Coronary Artery Calcium With Noncardiovascular Disease. The Multi-Ethnic Study of Atherosclerosis

AU - Handy, Catherine E.

AU - Desai, Chintan S.

AU - Dardari, Zeina A.

AU - Al-Mallah, Mouaz H.

AU - Miedema, Michael D.

AU - Ouyang, Pamela

AU - Budoff, Matthew J.

AU - Blumenthal, Roger S

AU - Nasir, Khurram

AU - Blaha, Michael

PY - 2015/8/4

Y1 - 2015/8/4

N2 - Objectives: This study sought to determine if coronary artery calcium (CAC) is associated with incident noncardiovascular disease. Background: CAC is considered a measure of vascular aging, associated with increased risk of cardiovascular and all-cause mortality. The relationship with noncardiovascular disease is not well defined. Methods: A total of 6,814 participants from 6 MESA (Multi-Ethnic Study of Atherosclerosis) field centers were followed for a median of 10.2 years. Modified Cox proportional hazards ratios accounting for the competing risk of fatal coronary heart disease were calculated for new diagnoses of cancer, pneumonia, chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD), deep vein thrombosis/pulmonary embolism, hip fracture, and dementia. Analyses were adjusted for age; sex; race; socioeconomic status; health insurance status; body mass index; physical activity; diet; tobacco use; number of medications used; systolic and diastolic blood pressure; total and high-density lipoprotein cholesterol; antihypertensive, aspirin, and cholesterol medication; and diabetes. The outcome was first incident noncardiovascular disease diagnosis. Results: Compared with those with CAC = 0, those with CAC >400 had an increased hazard of cancer (hazard ratio [HR]: 1.53; 95% confidence interval [CI]: 1.18 to 1.99), CKD (HR: 1.70; 95% CI: 1.21 to 2.39), pneumonia (HR: 1.97; 95% CI: 1.37 to 2.82), COPD (HR: 2.71; 95% CI: 1.60 to 4.57), and hip fracture (HR: 4.29; 95% CI: 1.47 to 12.50). CAC >400 was not associated with dementia or deep vein thrombosis/pulmonary embolism. Those with CAC = 0 had decreased risk of cancer (HR: 0.76; 95% CI: 0.63 to 0.92), CKD (HR: 0.77; 95% CI: 0.60 to 0.98), COPD (HR: 0.61; 95% CI: 0.40 to 0.91), and hip fracture (HR: 0.31; 95% CI: 0.14 to 0.70) compared to those with CAC >0. CAC = 0 was not associated with less pneumonia, dementia, or deep vein thrombosis/pulmonary embolism. The results were attenuated, but remained significant, after removing participants developing interim nonfatal coronary heart disease. Conclusions: Participants with elevated CAC were at increased risk of cancer, CKD, COPD, and hip fractures. Those with CAC = 0 are less likely to develop common age-related comorbid conditions, and represent a unique population of "healthy agers.".

AB - Objectives: This study sought to determine if coronary artery calcium (CAC) is associated with incident noncardiovascular disease. Background: CAC is considered a measure of vascular aging, associated with increased risk of cardiovascular and all-cause mortality. The relationship with noncardiovascular disease is not well defined. Methods: A total of 6,814 participants from 6 MESA (Multi-Ethnic Study of Atherosclerosis) field centers were followed for a median of 10.2 years. Modified Cox proportional hazards ratios accounting for the competing risk of fatal coronary heart disease were calculated for new diagnoses of cancer, pneumonia, chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD), deep vein thrombosis/pulmonary embolism, hip fracture, and dementia. Analyses were adjusted for age; sex; race; socioeconomic status; health insurance status; body mass index; physical activity; diet; tobacco use; number of medications used; systolic and diastolic blood pressure; total and high-density lipoprotein cholesterol; antihypertensive, aspirin, and cholesterol medication; and diabetes. The outcome was first incident noncardiovascular disease diagnosis. Results: Compared with those with CAC = 0, those with CAC >400 had an increased hazard of cancer (hazard ratio [HR]: 1.53; 95% confidence interval [CI]: 1.18 to 1.99), CKD (HR: 1.70; 95% CI: 1.21 to 2.39), pneumonia (HR: 1.97; 95% CI: 1.37 to 2.82), COPD (HR: 2.71; 95% CI: 1.60 to 4.57), and hip fracture (HR: 4.29; 95% CI: 1.47 to 12.50). CAC >400 was not associated with dementia or deep vein thrombosis/pulmonary embolism. Those with CAC = 0 had decreased risk of cancer (HR: 0.76; 95% CI: 0.63 to 0.92), CKD (HR: 0.77; 95% CI: 0.60 to 0.98), COPD (HR: 0.61; 95% CI: 0.40 to 0.91), and hip fracture (HR: 0.31; 95% CI: 0.14 to 0.70) compared to those with CAC >0. CAC = 0 was not associated with less pneumonia, dementia, or deep vein thrombosis/pulmonary embolism. The results were attenuated, but remained significant, after removing participants developing interim nonfatal coronary heart disease. Conclusions: Participants with elevated CAC were at increased risk of cancer, CKD, COPD, and hip fractures. Those with CAC = 0 are less likely to develop common age-related comorbid conditions, and represent a unique population of "healthy agers.".

KW - Aging

KW - Biologic aging

KW - Cancer

KW - Coronary artery calcium

KW - Coronary artery disease

UR - http://www.scopus.com/inward/record.url?scp=84959908257&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84959908257&partnerID=8YFLogxK

U2 - 10.1016/j.jcmg.2015.09.020

DO - 10.1016/j.jcmg.2015.09.020

M3 - Article

C2 - 26970999

AN - SCOPUS:84959908257

JO - JACC: Cardiovascular Imaging

JF - JACC: Cardiovascular Imaging

SN - 1936-878X

ER -