Cardiovascular and All-Cause Mortality Risk by Coronary Artery Calcium Scores and Percentiles Among Older Adult Males and Females
AUTHORS
- PMID: 32822664 [PubMed].
ABSTRACT
BACKGROUND: Coronary calcium is a marker of coronary atherosclerosis and established predictor of cardiovascular risk in general populations; however, there are limited studies examining its prognostic value among older adults (≥75 years) and even less regarding its utility in older males versus females. Accordingly, we sought to examine the prognostic significance of both absolute and percentile coronary calcium scores among older adults.
METHODS: The multi-center Coronary Artery Calcium Consortium consists of 66,636 asymptomatic patients without cardiovascular disease. Participants aged ≥75 were included in this study and stratified by sex. Multivariable Cox regression models were constructed to assess cardiovascular and all-cause mortality risk by Agatston coronary calcium scores and percentiles.
RESULTS: Among 2,474 asymptomatic patients (mean age 79 years, 10.4-year follow-up), prevalence of coronary artery calcium was 92%. For both sexes but in females more so than males, increased coronary calcium score and percentiles were associated with increased cardiovascular and all-cause mortality risk. Those at the lowest coronary calcium categories (0-9 and <25 percentile) had significantly lower risk of cardiovascular and all-cause mortality relative to the rest of the population. Multivariable analyses of traditional cardiovascular risk factors and coronary artery calcium variables revealed that age and coronary calcium were the strongest independent predictors for adverse outcomes.
CONCLUSIONS: Both coronary artery calcium scores and percentiles are strongly predictive of cardiovascular and all-cause mortality among older adults, with greater risk-stratification among females. Both low coronary artery calcium scores 0-9 and <25 percentile define relatively low risk older adults.
Tags: alumni publications 2020