The study examined whether high coronary artery calcium (CAC) in adults aged 30 to 45 predicts later death. It used 12,847 referred patients with clinically indicated scans from four US centres in the CAC Consortium. Over a median 22.6 years, 624 died: 149 from cardiovascular disease (CVD) and 81 from coronary heart disease (CHD). Against a CAC score of 0, a score above 90% gave an adjusted hazard ratio of 1.87 for all-cause death. For CVD and CHD death the ratios were 2.60 and 3.71, and modelled 30-year CHD mortality was 3.0% versus 0.6%. The cohort was referred rather than population-based, and 77% were male.
Why it is interesting: It links a scan finding in early middle age to cardiovascular death more than two decades later. The hazard ratio for coronary heart disease death, 3.71, is about twice that for all-cause death.
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