Author + information
- Parag Joshi,
- Birju Patel,
- Michael Blaha,
- Jarett Berry,
- Ron Blankstein,
- Matthew Budoff,
- Nathan Wong,
- Arthur Agatston,
- Roger Blumenthal and
- Khurram Nasir
The aim of our study is to identify predictors for coronary heart disease (CHD) events among individuals with a low lifetime risk of cardiovascular disease in a large, population-based, multi-ethnic population.
MESA is a cohort study of men and women aged 45-84 years and free of clinical cardiovascular disease at baseline. Low lifetime risk participants were identified as non-diabetic, non-smoking subjects with a total cholesterol ≤ 200 mg/dL, systolic BP ≤ 139 mmHg, and diastolic BP ≤ 89 mmHg. We assessed predictors of CHD events including age, gender, ethnicity, low HDL-C, C-reactive protein, family history of CHD, carotid intima-media thickness (CIMT) and coronary artery calcium (CAC). We calculated the number needed to scan (NNS) to identify CAC>0 and >100.
From 6,776 subjects, 1,391 (58.6 ± 10.2 yrs; 51% male) had low lifetime risk, of whom 479 (34%) had CAC>0 and 183 (13%) had CAC>100. Over a median follow-up of 7 years, there were only 24 events (1.7%). CAC was present in 18 (75%) subjects with an event. In multivariable analyses (Figure), only increasing CAC remained predictive of CHD. The event rate in those with CAC >0 and >100 was 5.4/1000 and 10.4/1000 person-years, respectively. The NNS to identify CAC>0 and CAC>100 were 3 and 7.6, respectively.
While event rates are low in those with low lifetime risk, CAC is the strongest predictor of CHD. Identification of these individuals carries significant potential therapeutic implications.
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Imaging: CT/Multimodality V
Abstract Category: 20. Imaging: CT/Multimodality
Presentation Number: 1228M-350
- 2013 American College of Cardiology Foundation