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Differentiation of severe coronary artery calcification in the Multi-Ethnic Study of Atherosclerosis.
MedLine Citation:
PMID:  21930271     Owner:  NLM     Status:  Publisher    
BACKGROUND: Coronary artery calcium (CAC) scores predict coronary heart disease (CHD) risk. Little is known, however, about the distinctive risk among asymptomatic individuals with very high CAC (≥1000) compared to high CAC (400-999). METHODS AND RESULTS: We compared CHD risk factors and event rates between participants with very high CAC (n=257) and high CAC (n=420) among adults free of clinical CHD in the Multi-Ethnic Study of Atherosclerosis (MESA). CAC was measured at baseline, and participants were followed for a median of 68 months. Very high CAC (≥1000), compared to high CAC (400-999), was associated with male gender (OR 3.10, p<0.001) and older age (OR 1.42 per 10 year increase, p<0.001). Chronic kidney disease (CKD) was associated with very high CAC (OR 1.66, p=0.009) with a greater prevalence of moderate CKD (GFR 30-59) in the ≥1000 group (25% vs. 18%). Those with very high CAC were more likely to develop angina (adjusted HR 1.72 [95% CI 1.03-2.90], p=0.04), but not more likely to experience myocardial infarction, resuscitated cardiac arrest, or CHD death (adjusted HR 1.17, [95% CI 0.64-2.12] p=0.61) compared to high CAC. Total CHD event rates were greater for very high CAC (3.7 per 100 person-years) compared to high CAC (2.6 per 100 person-years). CONCLUSIONS: Both high and very high CAC are associated with an elevated risk of CHD events in those without symptomatic CHD at baseline; however, very high CAC is associated with an increased risk of angina, but not CHD death or MI, compared to high CAC.
Megan Coylewright; Kenneth Rice; Matthew J Budoff; Roger S Blumenthal; Philip Greenland; Richard Kronmal; R Graham Barr; Gregory L Burke; Russell Tracy; Wendy S Post
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-31
Journal Detail:
Title:  Atherosclerosis     Volume:  -     ISSN:  1879-1484     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-9-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0242543     Medline TA:  Atherosclerosis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
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