Prevention & lipidsResearch article
Zero Coronary Artery Calcium as a Marker of Vascular Resilience in High-Risk Adults
- Multi-Ethnic Study of Atherosclerosis analysis
- Cox models adjusted for age, sex, and race/ethnicity
- Kaplan-Meier methods
Authors' conclusion
Nearly one-quarter of adults labeled high ASCVD risk had CAC = 0 and accrued few events despite similar risk factor burden. CAC = 0 may mark a resilient phenotype warranting targeted mechanistic investigation.
Study context
- Population
- Adults with Pooled Cohort Equations-estimated atherosclerotic cardiovascular disease (ASCVD) risk ≥20% and coronary artery calcium (CAC) datamean age 73.2 years, 61.4% men
- Participants
- 1,608 adults
- Comparison
- CAC = 0 vs CAC >0
- CAC = 0n = 359
Main finding
Hard CHD incidence · 10 years
Hazard ratio
0.27
95% CI 0.15–0.49
By group
CAC = 0 vs CAC >0
HR 0.27 (95% CI 0.15–0.49)
As reported in the abstract
Further findings
Prevalence of CAC = 0
- CAC = 0
- 359 (22.3%)
Risk factor profiles
- standardized mean differences for blood pressure, lipids, diabetes, and body mass index
- <0.20
Original publication
Zero Coronary Artery Calcium as a Marker of Vascular Resilience in High-Risk Adults. JACC Adv. Published 20 July 2026. doi:10.1016/j.jacadv.2026.103031
Summarised from the published abstract; every number is checked against it