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Coronary artery calcium progression may increase risk for CVD event

Progression of coronary artery calcium was associated with a composite CVD event in asymptomatic individuals, according to findings published in the Journal of the American Board of Family Medicine.

“Studying the significance of [coronary artery calcium (CAC)] in asymptomatic individuals is warranted because the majority of initial coronary heart disease events are acute myocardial infarctions or sudden cardiac death,” Roberto Cardarelli, DO, MHA, MPH, from the department of family and community medicine at the University of Kentucky College of Medicine, Lexington, and colleagues wrote.

“Understanding the relationship between specific risk factors and CAC progression may improve the mechanistic understanding of coronary heart disease. ... Less evidence is available for factors related specifically to CAC progression, and less still is consistent,” they added.

The researchers examined the association of select cardiovascular risk factors with the progression of CAC over a 2-year period, and the association between CAC progression and experiencing a composite CVD event. They obtained repeated CAC measurements for 311 asymptomatic primary care participants aged more than 44 years.

In total, 30% of participants showed CAC progression, whereas 70% demonstrated no change or decrease in CAC over the 2-year period. Dyslipidemia, systolic blood pressure, fasting glucose and non-HDL were CV risk factors associated with 2-year CAC progression in adjusted regression models that controlled for age and sex. In addition, after controlling for known risk factors, participants with progressive CAC measures were more than four times as likely to have a composite CVD event at 2 years.

“While our study only speaks to the association between 2-year CAC changes, traditional risk factors and composite CVD events, these findings lay the groundwork for future studies to identify those who might benefit from more aggressive treatment and/or further diagnostic workup and to evaluate the efficacy of risk factor modification or other medical treatments on plaque burden,” Cardarelli and colleagues wrote. “Further studies are needed to determine how the source and extent of traditional cardiovascular risk factors interact with specific levels of CAC progression and the impact this has on cardiovascular morbidity and mortality.” – by Savannah Demko

Disclosures: The authors report no relevant financial disclosures.