Risk profile and prognostic implications of premature advanced coronary atherosclerotic disease among young to early middle-aged adults: the coronary artery calcium consortium
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
Methodological detailsmultivariable-adjusted, competing risks regression
- Multivariable-adjusted
- Competing risks regression
Main finding
As reported in the abstract
Mortality incidence per 1000 person-years
CAC ≥ 90th percentile
- All-cause
- 2.93
- CV
- 1.11
- CHD
- 0.65
CAC < 90th percentile
- All-cause
- 1.85
- CV
- 0.39
- CHD
- 0.19
No CAC
- All-cause
- 1.11
- CV
- 0.21
- CHD
- 0.08
All-cause
CAC ≥ 90th percentile2.93
CAC < 90th percentile1.85
No CAC1.11
CV
CAC ≥ 90th percentile1.11
CAC < 90th percentile0.39
No CAC0.21
CHD
CAC ≥ 90th percentile0.65
CAC < 90th percentile0.19
No CAC0.08
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
| Outcome | CAC ≥ 90th percentile | CAC < 90th percentile | No CAC | |
|---|---|---|---|---|
| Multivessel CAC | 76.4% | 40.6% | Not reported in the abstract | No CAC: 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.
Summarised from the published abstract; every number is checked against it