Higher coronary artery calcium scores were strongly associated with increased CVD mortality in young adults, with a sub-distribution hazard ratio of 74.1 (95% CI 18.98-239.3) for CACS >300 vs 0.
Cohort (n=160,821)
Does higher coronary artery calcium score (CACS) predict cardiovascular and non-cardiovascular mortality in young and older CVD-free adults?
Higher coronary artery calcium scores are strongly associated with increased cardiovascular mortality in young adults, suggesting a potential role for early risk stratification and intervention even at low CACS.
Effect estimate: SHR 74.1 (95% CI 18.98-239.3)
AIMS: The role of coronary artery calcium score (CACS) in predicting cardiovascular disease (CVD) and non-CVD mortality in young adults is unclear. We investigated the association of CACS with CVD and non-CVD mortality in young and older individuals. METHODS AND RESULTS: CVD-free Koreans (n = 160 821; mean age, 41.4 years; 73.2% young individuals aged 300 to 0 CACS were 5.67 (2.33-13.78), 22.34 (5.72-87.19), and 74.1 (18.98-239.3), respectively, and among older individuals, corresponding SHR were 1.51 (0.60-3.84), 8.57 (3.05-24.06), and 6.41 (1.98-20.74). The addition of CACS to Framingham risk score significantly but modestly improved risk prediction for CVD mortality in young individuals. Conversely, CACS was significantly associated with non-CVD mortality only in older individuals. CONCLUSIONS: Strong associations of CACS with CVD mortality, but not non-CVD mortality, were observed in young individuals, beginning in the low CACS category. Our findings reaffirm the need for early intervention for young adults even with low CACS to reduce CVD mortality.
Kang et al. (2022) conducted a cohort in CVD-free (n=160,821). Coronary artery calcium score (CACS) vs. CACS of 0 was evaluated on CVD mortality (SHR 74.1, 95% CI 18.98-239.3). Higher coronary artery calcium scores were strongly associated with increased CVD mortality in young adults, with a sub-distribution hazard ratio of 74.1 (95% CI 18.98-239.3) for CACS >300 vs 0.