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

2012; Oxford University Press; Volume: 33; Issue: 23 Linguagem: Inglês

10.1093/eurheartj/ehs230

1522-9645

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 A. Rumberger, Tracy Q. Callister, J. Rivera, Arthur Agatston, Khurram Nasir,

Cardiovascular Disease and Adiposity

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. We 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 ( 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 [ 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 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%). The 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.