Among postmenopausal women with a coronary artery calcium score of 0, early menopause was associated with a significantly higher 15-year risk of incident ASCVD (HR 1.96) compared to women without early menopause.
Cohort (n=2,456)
Yes
Does coronary artery calcium (CAC) scoring improve atherosclerotic cardiovascular disease (ASCVD) risk stratification in postmenopausal women with early menopause?
In postmenopausal women with early menopause and a CAC score of 0, the 15-year risk of ASCVD is significantly elevated compared to those without early menopause, supporting the use of CAC for long-term risk stratification in this population.
Effect estimate: HR 1.96 (95% CI 1.26-3.04)
Absolute Event Rate: 11.4% vs 6.4%
p-value: p=<0.01
Background and Aims: We aimed to determine the utility of coronary artery calcium (CAC) for atherosclerotic cardiovascular disease (ASCVD) risk stratification in women with and without early menopause (EM). Methods: To examine the association between CAC and incident ASCVD, we performed Kaplan-Meier survival analysis and multivariable Cox proportional hazards modeling using data from 2,456 postmenopausal women in the Multi-Ethnic Study of Atherosclerosis (MESA) with or without EM, defined as occurring at 50% of middle-aged postmenopausal women with EM had CAC = 0, similar to those without EM. Among women with CAC = 0, those with EM had a low to borderline 10-year risk of ASCVD, but the 15-year risk was significantly higher for women with EM versus those without EM. When CAC ≥ 1, the incidence of ASCVD was similar for women with and without EM. These findings support the use of CAC to help improve ASCVD risk stratification in women with EM. Condensed abstract: This study investigated the association between coronary artery calcium (CAC) and incident atherosclerotic cardiovascular disease (ASCVD) in postmenopausal women with and without early menopause (EM). We found that >50% of women had CAC = 0 and an associated low-to-borderline 10-year cumulative incidence of ASCVD. However, the risk for ASCVD was significantly higher for women with EM after 15-years follow-up. Additional research is needed to better understand the differences in long-term ASCVD risk between women with and without EM who have CAC = 0.
Chu et al. (Mon,) conducted a cohort in Early menopause and atherosclerotic cardiovascular disease risk (n=2,456). Early menopause (< 45 years of age) vs. No early menopause was evaluated on Incident ASCVD over 15 years in women with CAC = 0 (HR 1.96, 95% CI 1.26-3.04, p=<0.01). Among postmenopausal women with a coronary artery calcium score of 0, early menopause was associated with a significantly higher 15-year risk of incident ASCVD (HR 1.96) compared to women without early menopause.