Advanced Subclinical Atherosclerosis in Young Individuals and Risk of Mortality Over 30 Years: The Coronary Artery Calcium Consortium
Authors' conclusion
Results of this cohort study suggest that young adults with a CAC score greater than 90% face significantly higher long-term risk of all-cause, CVD, and CHD mortality, suggesting potential implications for guiding the intensification of preventive intervention in this high-risk phenotype.
Study context
- Population
- Adults aged 30 to 45 years from the coronary artery calcium (CAC) Consortiummean (SD) age 40.5 (3.6) years, 9922 (77.2%) male, 624 deaths (149 cardiovascular disease (CVD) and 81 coronary heart disease (CHD))
- Participants
- 12,847 adults
- Exposure
- CAC score greater than 90% vs CAC score of 0
- CAC score greater than 90%n = 1,703
- CAC score between 75% to 90%n = 1,626
- CAC score of 0n = 9,262reference
- Outcome
- All-cause, CVD, and CHD mortality
- Follow-up
- Median 22.6 years
Methodological detailsretrospectively assembled cohort of referred individuals with clinically indicated CAC scans, multivariable regression models for time-to-event analysis, four US institutions, median follow-up 22.6 years
- Retrospectively assembled cohort of referred individuals with clinically indicated CAC scans
- Multivariable regression models for time-to-event analysis
- Four US institutions
- Median follow-up 22.6 years
Main finding
As reported in the abstract
CAC score greater than 90% vs CAC score of 0Hazard ratio (95% CI)
All-cause mortality
1.87(1.54–2.27)
CVD mortality
2.60(1.77–3.82)
CHD mortality
3.71(2.24–6.16)
Observational data: associations, not effects.
Further findings
| Outcome | CAC score greater than 90% | CAC score between 75% to 90% | CAC score of 0 | |
|---|---|---|---|---|
| Modeled risk of all-cause, CVD, and CHD mortality · 30 years | ||||
| All-cause | 12.9% | Not reported in the abstract | 7.5% | CAC score between 75% to 90%: not reported in the abstract |
| CVD | 4.5% | Not reported in the abstract | 1.5% | CAC score between 75% to 90%: not reported in the abstract |
| CHD | 3.0% | Not reported in the abstract | 0.6% | CAC score between 75% to 90%: not reported in the abstract |
- Modeled risk of all-cause, CVD, and CHD mortality: significantly higher with CAC score greater than 90%
Original publication
Advanced Subclinical Atherosclerosis in Young Individuals and Risk of Mortality Over 30 Years: The Coronary Artery Calcium Consortium. JAMA Cardiol. Published 23 October 2026. doi:10.
Summarised from the published abstract; every number is checked against it