American Journal of Epidemiology Advance Access originally published online on August 2, 2005
American Journal of Epidemiology 2005 162(5):421-429; doi:10.1093/aje/kwi228
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ORIGINAL CONTRIBUTIONS |
Coronary Artery Calcium Score and Coronary Heart Disease Events in a Large Cohort of Asymptomatic Men and Women
1 Centers for Integrated Health Research, The Cooper Institute, Dallas, TX
2 The Cooper Clinic, Dallas, TX
3 Institute for Exercise and Environmental Medicine, Presbyterian Hospital, Dallas, TX
4 University of Texas Southwestern Medical Center, Dallas, TX
Correspondence to Dr. Michael J. LaMonte, The Cooper Institute, 12330 Preston Road, Dallas, TX 75230 (e-mail: mlamonte{at}cooperinst.org).
Coronary artery calcium (CAC), a measure of subclinical coronary heart disease (CHD), may be useful in identifying asymptomatic persons at risk of CHD events. The current study included 10,746 adults who were 22–96 years of age, were free of known CHD, and had their CAC quantified by electron-beam tomography at baseline as part of a preventive medical examination at the Cooper Clinic (Dallas, Texas) during 1995–2000. During a mean follow-up of 3.5 years, 81 hard events (CHD death, nonfatal myocardial infarction) and 287 total events (hard events plus coronary revascularization) occurred. Age-adjusted rates (per 1,000 person-years) of hard events were computed according to four CAC categories: no detectable CAC and incremental sex-specific thirds of detectable CAC; these rates were, respectively, 0.4, 1.5, 4.8, and 8.7 (trend p < 0.0001) for men and 0.7, 2.3, 3.1, and 6.3 (trend p = 0.02) for women. CAC levels also were positively associated with rates of total CHD events for women and men (trend p < 0.0001 each). The association between CAC and CHD events remained significant after adjustment for CHD risk factors. CAC was associated with CHD events in persons with no baseline CHD risk factors and in younger (aged <40 years) and older (aged >65 years) study participants. These findings show that CAC is associated with an increased risk of CHD events in asymptomatic women and men.
arteries; calcium; cohort studies; coronary disease; primary prevention
Abbreviations: CAC, coronary artery calcium; CHD, coronary heart disease; EBT, electron-beam tomography
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