Coronary Artery Calcium Score Improves Risk Prediction In Younger Adults

Dr. Andre R. M. Paixao MD Division of Cardiology Department of Internal Medicine Washington Hospital Center Washington, DC

Dr. Andre R. M. Paixao MD Interview with:
Dr. Andre R. M. Paixao MD
Division of Cardiology
Arkansas Heart Hospital
Little Rock, AR.

Medical Research: What is the background for this study?

Dr. Paixao: Coronary artery calcium (CAC) measured by computed tomography has emerged as a powerful predictor of coronary heart disease (CHD) but most of the evidence behind it comes from cohorts comprised of older individuals (mean age 62 years).Coronary artery calcium has a very strong association with age and young individuals tend to have a higher proportion of noncalcified plaque so validating the predictive value of CAC in a younger cohort is of extreme importance.  

Medical Research: What are the main findings?

Dr. Paixao: Using data from the Dallas Heart Study, a multi-ethnic cohort comprised of younger individuals (mean age 44 years), the addition of Coronary artery calcium to a traditional risk factor model significantly improved discrimination and risk classification (change in c-statistic = 0.03; NRI = 0.216, p = 0.012).

We also performed a meta-analysis of prior studies and observed that our findings are of similar magnitude to those reported in older individuals (NRI = 0.200).

Medical Research: What should clinicians and patients take away from your report?

Dr. Paixao: Our study suggests that  Coronary artery calcium scanning is a reasonable tool to improve Coronary Heart Disease risk prediction in individuals younger than those previously studied (~45 years) and at the lower end of the age group targeted by recent guidelines (40 – 79 years).

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Paixao: Although we show that  Coronary artery calcium improves risk prediction in a population younger than previously studied, the minimal age at which CAC becomes informative has yet to be determined. Given the overall low event rates among young individuals, this type of analysis will require data pooling from multiple different cohorts.


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Dr. Andre R. M. Paixao MD (2015). Coronary Artery Calcium Score Improves Risk Prediction In Younger Adults