title: Coronary artery calcium for the prediction of mortality in young adults <45 years old and elderly adults >75 years old.
abstract: OBJECTIVE
  To determine if coronary artery calcium (CAC) scoring is independently predictive of mortality in young adults and in the elderly population and if a young person with high CAC has a higher mortality risk than an older person with less CAC.
  
  
  RESULTS
  We studied a cohort of 44 052 asymptomatic patients referred for CAC scans for cardiovascular risk stratification. All-cause mortality rates (MRs) were calculated after stratifying by age groups (<45, 45-54, 55-64, 65-74, and ≥75) and CAC score (0, 1-100, 100-400, and >400). Multivariable Cox regression models were constructed to assess the independent value of CAC for predicting all-cause mortality in the <45- and ≥75-year-old age groups. The MR increased in both the <45- and ≥75-year-old age groups with an increasing CAC group. After multivariable adjustment, increasing CAC remained independently predictive of increased mortality compared with CAC = 0 [<45 age group, hazard ratio (95% confidence interval): CAC = 1-100, 2.3 (1.2-4.2); CAC = 100-400, 7.4 (3.3-16.6); CAC > 400, 34.6 (15.5-77.4); ≥75 age group: CAC = 1-100, 7.0 (2.4-20.8); CAC = 100-400, 9.2 (3.2-26.5); CAC > 400, 16.1 (5.8-45.1)]. Persons <45 years old with CAC = 100-400 and CAC > 400 had 2- and 10-fold increased MRs, respectively, compared with persons ≥75 with no CAC. Individuals ≥75 years old with CAC = 0 had a 5.6-year survival rate of 98%, similar to those in other age groups with CAC = 0 (5.6-year survival, 99%).
  
  
  CONCLUSIONS
  The value of CAC for predicting mortality extends to both elderly patients and those <45 years old. Elderly persons with no CAC have a lower MR than younger persons with high CAC.
authors: Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA.
authors: Rajesh
authors: R
authors: Tota-Maharaj
authors: Michael J
authors: MJ
authors: Blaha
authors: John W
authors: JW
authors: McEvoy
authors: Roger S
authors: RS
authors: Blumenthal
authors: Evan D
authors: ED
authors: Muse
authors: Matthew J
authors: MJ
authors: Budoff
authors: Leslee J
authors: LJ
authors: Shaw
authors: Daniel S
authors: DS
authors: Berman
authors: Jamal S
authors: JS
authors: Rana
authors: John
authors: J
authors: Rumberger
authors: Tracy
authors: T
authors: Callister
authors: Juan
authors: J
authors: Rivera
authors: Arthur
authors: A
authors: Agatston
authors: Khurram
authors: K
authors: Nasir
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003324:Coronary Artery Disease / Q000401:mortality*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061205:Vascular Calcification / Q000401:mortality*; D055815:Young Adult