Relationship between coronary artery calcification and other measures of subclinical cardiovascular disease in older adults.
BACKGROUND
In the Cardiovascular Health Study, subclinical cardiovascular disease (CVD) predicted CVD events in older adults. The extent to which this measure or its components reflect calcified coronary disease is unknown.


RESULTS
Coronary artery calcium (CAC) was assessed with electron beam tomography in 414 participants without clinical CVD and examined using cut points (CAC> or =400 and CAC> or =800) and the log(CAC); 274 had subclinical CVD by ankle-arm index, ECG, or carotid ultrasound. Cut points for subclinical disease as previously defined in the Cardiovascular Health Study were examined as well as continuous measures to produce receiver operating characteristic curve curves. A low ankle-arm index was highly specific for a high CAC score. The internal carotid artery intima-media thickness was most strongly correlated with CAC (r=0.30) and was significantly related to both CAC cut points and to the log(CAC) score independently of all other measures.


CONCLUSIONS
In these community-dwelling older adults without clinical CVD, internal carotid artery intima-media thickness was most closely related to CAC. However, 17.5% of those with a CAC> or =400 would be missed in the ascertainment of subclinical atherosclerosis using the previously published composite of subclinical atherosclerosis. Prospective follow-up will determine whether the CAC score improves prediction of CVD events over other noninvasive measures.
Newman
Anne B
AB
Division of Geriatric Medicine, University of Pittsburgh, Pa 15213, USA. anewman@pitt.edu
Naydeck
Barbara L
BL
Sutton-Tyrrell
Kim
K
Edmundowicz
Daniel
D
O'Leary
Daniel
D
Kronmal
Richard
R
Burke
Gregory L
GL
Kuller
Lewis H
LH
D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000453:epidemiology* / Q000473:pathology; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000473:pathology; D016893:Carotid Stenosis / Q000453:epidemiology / Q000473:pathology; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000473:pathology; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012737:Sex Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology