Research Highlights: Coronary Artery Calcium Volume May Be Early Predictor of Heart Disease

Coronary Artery Calcium Volume May Be Early Predictor of Heart Disease

A study recently published in the Journal of the American Medical Association (JAMA) has suggested that individuals with large amounts of coronary artery calcium are at a greater risk for cardiovascular disease events such as stroke and cardiac arrest. Coronary artery calcium (CAC) has long been considered a predictor for cardiovascular disease events, but very little research has yet explored the particular measure of CAC that is the most effective predictor. This study looked specifically at both CAC volume and density and examined the association between these factors and cardiovascular disease.
Experimenters measured the CAC volume of a group of men and women between the ages of 45 and 84 with no history of heart disease or events. Of this group, 3398 individuals had CAC levels greater than zero and these individuals went on to participate in the study. Experimenters also tested participants for cardiovascular risk factors. The study began with these tests in 2000-2002 at six different field centers across the United States and a follow-up continued until 2008-2010 with the mean follow-up time being 7.6 years. Experimenters used electron-beam CT scanners to measure starting CAC volume and density in participants.
Overall, 265 cardiovascular disease events occurred during this study. Experimenters found that the higher an individual’s CAC volume was, the more likely they were to experience cardiovascular disease events. Thus, this study showed a strong association between CAC volume and cardiovascular disease. Experimenters noted that measuring CAC volume could be an excellent predictor for cardiovascular disease in people who are at an intermediate risk level.
Unlike participants with high CAC volume, individuals with high CAC density did not experience more events than those with low CAC density. In fact, experimenters measured an inverse association between cardiovascular disease events and CAC density, which is in accordance with other current research. Based on these results, experimenters advised that CAC density should be taken into account when testing patients for cardiovascular disease risk, not simply CAC volume. This research is thus important, as it not only supports CAC volume as a predictor of heart disease, but also reveals how measurements of cardiovascular disease risk may be inaccurate if CAC density is not also considered.

JAMA. 2014;311(3):271-278

 
Caroline Russell-Troutman is the 2013-2014 Research Highlights Editor