Prevention & lipidsCohort study

Risk profile and prognostic implications of premature advanced coronary atherosclerotic disease among young to early middle-aged adults: the coronary artery calcium consortium

Eur J Prev CardiolPublished

  • Retrospective cohort study
  • multivariable-adjusted
  • competing risks regression

Authors' conclusion

Premature advanced atherosclerosis is a distinct clinical phenotype that strongly predicts all-cause and cause-specific mortality.

Study context

Population
Young to early middle-aged adults with no prior CVD history, Coronary Artery Calcium (CAC) Consortium18,561 (42.2%) had CAC
Participants
44,047 participants
Exposure
CAC ≥90th percentile vs CAC <90th percentile vs no CAC
  • CAC ≥ 90th percentilen = 6,680
Outcome
All-cause, CV and CHD mortality
Follow-up
Mean 12.5 ± 3.6 years

Main finding

As reported in the abstract

Mortality incidence per 1000 person-years

CAC ≥ 90th percentile

2.93

All-cause · CV 1.11 · CHD 0.65

CAC < 90th percentile

1.85

All-cause · CV 0.39 · CHD 0.19

No CAC

1.11

All-cause · CV 0.21 · CHD 0.08

CAC ≥ 90th percentile vs No CACEstimate (CI)
all-cause mortality, multivariable-adjusted
HR 2.17(1.83–2.57)
CV mortality
SHR 3.89(2.78–5.44)
CHD mortality
SHR 5.45(3.38–8.78)

Observational data: associations, not effects.

Further findings

OutcomeCAC ≥ 90th percentileCAC < 90th percentileNo CAC
Multivessel CAC76.4%40.6%Not reported in the abstract

Mortality by sex in advanced CAC (subgroup)

No difference in mortality between men and women with advanced CAC

Original publication

Risk profile and prognostic implications of premature advanced coronary atherosclerotic disease among young to early middle-aged adults: the coronary artery calcium consortium. Eur J Prev Cardiol. Published 16 January 2025. doi:10.1093/eurjpc/zwaf019

Summarised from the published abstract; every number is checked against it