Abstract
Although the traditional Agatston coronary artery calcium (CAC) score is a powerful predictor of mortality, it is unknown if the regional distribution of CAC further improves cardiovascular risk prediction. We retrospectively studied 23,058 patients referred for Agatston CAC scoring, of whom 61% had CAC (n=14,084). CAC distribution was defined as the number of vessels with CAC (0 to 4, including left main). For multivessel CAC, "diffuse" CAC was defined by decreasing percentage of CAC in the single most affected vessel and by ≤75% total Agatston CAC score in the most calcified vessel. All-cause mortality was ascertained through the social security death index. The mean age was 55±11 years, with 69% men. There were 584 deaths (2.5%) over 6.6±1.7 years. Considerable heterogeneity existed between the Agatston CAC score group and the number of vessels with CAC. In each CAC group, increasing number of vessels with CAC was associated with an increased mortality rate. After adjusting for age, gender, Agatston CAC score, and cardiovascular risk factors, increasing number of vessels with CAC was associated with higher mortality risk compared with single-vessel CAC (2-vessel: HR 1.61 [95% CI 1.14 to 2.25], 3-vessel: 1.99 [1.44 to 2.77], ...Continue Reading
References
Mar 15, 1990·Journal of the American College of Cardiology·A S AgatstonR Detrano
Mar 1, 1988·Journal of the American College of Cardiology·P H StoneJ T Willerson
Jun 1, 1974·Circulation·A G BartelR G Lester
Oct 15, 1995·Circulation·J A RumbergerR S Schwartz
Mar 1, 1996·Circulation·M J BudoffB H Brundage
Jan 13, 1998·Journal of the American College of Cardiology·G SangiorgiR S Schwartz
Nov 24, 2004·Circulation·Shoichi EharaMakiko Ueda
Sep 18, 2007·Journal of the American College of Cardiology·James K MinTracy Q Callister
Nov 26, 2010·Circulation·Philip GreenlandUNKNOWN American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
Aug 13, 2011·Journal of the American College of Cardiology·James K MinUNKNOWN CONFIRM Investigators
Jan 10, 2012·Diabetes Care·Michael Gordon SilvermanKhurram Nasir
Jul 31, 2012·European Heart Journal·Rajesh Tota-MaharajKhurram Nasir
Sep 26, 2013·The American Journal of Cardiology·Jonathan D NewmanUNKNOWN ARIC Study Investigators
Nov 20, 2013·JAMA : the Journal of the American Medical Association·Michael H CriquiMatthew A Allison
Feb 20, 2014·Circulation. Cardiovascular Imaging·Marcio Sommer BittencourtRon Blankstein
Dec 7, 2014·Atherosclerosis·Rajesh Tota-MaharajMichael J Blaha
Jan 15, 2015·Atherosclerosis·Krishna AlluriMichael J Blaha
Citations
Apr 18, 2016·JACC. Cardiovascular Imaging·Michael J BlahaKhurram Nasir
Apr 5, 2016·The Journal of Physiology·Jessica L RuizJoshua D Hutcheson
Nov 14, 2018·Journal of Computer Assisted Tomography·Nagina MalguriaElliot K Fishman
Apr 4, 2020·American Journal of Epidemiology·Jonathan T UnkartMichael H Criqui
Feb 18, 2016·Current Atherosclerosis Reports·Sina KianoushMichael J Blaha
Nov 23, 2019·Current Atherosclerosis Reports·Hong Loan NguyenTina Shah
May 24, 2020·Heart and Vessels·Kazuhiro OsawaHiroshi Ito
May 23, 2018·Journal of Lipids·Moshrik Abd AlamirMathew Budoff
Oct 6, 2020·Journal of Internal Medicine·B Y C CheongR Muthupillai
Jan 10, 2021·Journal of Clinical Lipidology·Carl E OrringerTerry A Jacobson
Aug 22, 2020·The American Journal of Medicine·Frances M WangDaniel S Berman
Apr 8, 2019·Atherosclerosis·Steven J LahtiMichael J Blaha
Mar 30, 2021·Radiology. Cardiothoracic Imaging·Olufunmilayo H ObisesanMichael J Blaha
Jul 30, 2021·European Heart Journal Cardiovascular Imaging·David J WinkelSaikiran Rapaka
Aug 19, 2021·Clinical Radiology·J GrabyJ C L Rodrigues
Aug 28, 2021·Life·Marko KumricJosko Bozic
Mar 16, 2019··Brendan L. EckYingnan Song
Mar 3, 2017··Steven MarkowitzAnthony P. Reeves