Distribution of Coronary Artery Calcium by Age, Sex, and Race Among Patients 30-45 Years Old

Aamir Javaid; Zeina A. Dardari; Joshua D. Mitchell; Seamus P. Whelton; Omar Dzaye; Joao A.C. Lima; Donald M. Lloyd-Jones; Matthew Budoff; Khurram Nasir; Daniel S. Berman; John Rumberger; Michael D. Miedema; Todd C. Villines; Michael J. Blaha

doi:10.1016/j.jacc.2022.02.051

Distribution of Coronary Artery Calcium by Age, Sex, and Race Among Patients 30-45 Years Old

Aamir Javaid, Zeina A. Dardari, Joshua D. Mitchell, Seamus P. Whelton, Omar Dzaye, Joao A.C. Lima, Donald M. Lloyd-Jones, Matthew Budoff, Khurram Nasir, Daniel S. Berman, John Rumberger, Michael D. Miedema, Todd C. Villines, Michael J. Blaha^*

^*Corresponding author for this work

Preventive Medicine

Research output: Contribution to journal › Article › peer-review

47 Scopus citations

Abstract

Background: Coronary artery calcium (CAC) is a measure of atherosclerotic burden and is well-validated for risk stratification in middle- to older-aged adults. Few studies have investigated CAC in younger adults, and there is no calculator for determining age-, sex-, and race-based percentiles among individuals aged <45 years. Objectives: The purpose of this study was to determine the probability of CAC >0 and develop age-sex-race percentiles for U.S. adults aged 30-45 years. Methods: We harmonized 3 datasets—CARDIA (Coronary Artery Risk Development in Young Adults), the CAC Consortium, and the Walter Reed Cohort—to study CAC in 19,725 asymptomatic Black and White individuals aged 30-45 years without known atherosclerotic cardiovascular disease. After weighting each cohort equally, the probability of CAC >0 and age-sex-race percentiles of CAC distributions were estimated using nonparametric techniques. Results: The prevalence of CAC >0 was 26% among White males, 16% among Black males, 10% among White females, and 7% among Black females. CAC >0 automatically placed all females at >90th percentile. CAC >0 placed White males at the 90th percentile at age 34 years compared with Black males at age 37 years. An interactive webpage allows one to enter an age, sex, race, and CAC score to obtain the corresponding estimated percentile. Conclusions: In a large cohort of U.S. adults aged 30-45 years without symptomatic atherosclerotic cardiovascular disease, the probability of CAC >0 varied by age, sex, and race. Estimated percentiles may help interpretation of CAC scores among young adults relative to their age-sex-race matched peers and can henceforth be included in CAC score reporting.

Original language	English (US)
Pages (from-to)	1873-1886
Number of pages	14
Journal	Journal of the American College of Cardiology
Volume	79
Issue number	19
DOIs	https://doi.org/10.1016/j.jacc.2022.02.051
State	Published - May 17 2022

Funding

CARDIA is conducted and supported by the National Heart, Lung, and Blood Institute in collaboration with the University of Alabama at Birmingham (HHSN268201800005I and HHSN268201800007I), Northwestern University (HHSN268201800003I), University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I). The Coronary Artery Calcium Consortium was supported by grant L30 HL110027. The authors have reported that they have no relationships relevant to the contents of this paper to disclose. This paper has been reviewed by CARDIA for scientific content. The online calculator was created by Rehan Javaid, University of Virginia School of Engineering Class of 2023.

Keywords

cardiovascular diseases
cardiovascular risk
coronary artery calcium
coronary artery disease
multidetector computed tomography
percentiles
premature atherosclerosis
primary prevention
young adults

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jacc.2022.02.051

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Javaid, A., Dardari, Z. A., Mitchell, J. D., Whelton, S. P., Dzaye, O., Lima, J. A. C., Lloyd-Jones, D. M., Budoff, M., Nasir, K., Berman, D. S., Rumberger, J., Miedema, M. D., Villines, T. C., & Blaha, M. J. (2022). Distribution of Coronary Artery Calcium by Age, Sex, and Race Among Patients 30-45 Years Old. Journal of the American College of Cardiology, 79(19), 1873-1886. https://doi.org/10.1016/j.jacc.2022.02.051

@article{3976ccb097324a099bc4c8c0758c3f51,

title = "Distribution of Coronary Artery Calcium by Age, Sex, and Race Among Patients 30-45 Years Old",

abstract = "Background: Coronary artery calcium (CAC) is a measure of atherosclerotic burden and is well-validated for risk stratification in middle- to older-aged adults. Few studies have investigated CAC in younger adults, and there is no calculator for determining age-, sex-, and race-based percentiles among individuals aged <45 years. Objectives: The purpose of this study was to determine the probability of CAC >0 and develop age-sex-race percentiles for U.S. adults aged 30-45 years. Methods: We harmonized 3 datasets—CARDIA (Coronary Artery Risk Development in Young Adults), the CAC Consortium, and the Walter Reed Cohort—to study CAC in 19,725 asymptomatic Black and White individuals aged 30-45 years without known atherosclerotic cardiovascular disease. After weighting each cohort equally, the probability of CAC >0 and age-sex-race percentiles of CAC distributions were estimated using nonparametric techniques. Results: The prevalence of CAC >0 was 26% among White males, 16% among Black males, 10% among White females, and 7% among Black females. CAC >0 automatically placed all females at >90th percentile. CAC >0 placed White males at the 90th percentile at age 34 years compared with Black males at age 37 years. An interactive webpage allows one to enter an age, sex, race, and CAC score to obtain the corresponding estimated percentile. Conclusions: In a large cohort of U.S. adults aged 30-45 years without symptomatic atherosclerotic cardiovascular disease, the probability of CAC >0 varied by age, sex, and race. Estimated percentiles may help interpretation of CAC scores among young adults relative to their age-sex-race matched peers and can henceforth be included in CAC score reporting.",

keywords = "cardiovascular diseases, cardiovascular risk, coronary artery calcium, coronary artery disease, multidetector computed tomography, percentiles, premature atherosclerosis, primary prevention, young adults",

author = "Aamir Javaid and Dardari, {Zeina A.} and Mitchell, {Joshua D.} and Whelton, {Seamus P.} and Omar Dzaye and Lima, {Joao A.C.} and Lloyd-Jones, {Donald M.} and Matthew Budoff and Khurram Nasir and Berman, {Daniel S.} and John Rumberger and Miedema, {Michael D.} and Villines, {Todd C.} and Blaha, {Michael J.}",

note = "Publisher Copyright: {\textcopyright} 2022 American College of Cardiology Foundation",

year = "2022",

month = may,

day = "17",

doi = "10.1016/j.jacc.2022.02.051",

language = "English (US)",

volume = "79",

pages = "1873--1886",

journal = "Journal of the American College of Cardiology",

issn = "0735-1097",

publisher = "Elsevier Inc.",

number = "19",

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Javaid, A, Dardari, ZA, Mitchell, JD, Whelton, SP, Dzaye, O, Lima, JAC, Lloyd-Jones, DM, Budoff, M, Nasir, K, Berman, DS, Rumberger, J, Miedema, MD, Villines, TC & Blaha, MJ 2022, 'Distribution of Coronary Artery Calcium by Age, Sex, and Race Among Patients 30-45 Years Old', Journal of the American College of Cardiology, vol. 79, no. 19, pp. 1873-1886. https://doi.org/10.1016/j.jacc.2022.02.051

TY - JOUR

T1 - Distribution of Coronary Artery Calcium by Age, Sex, and Race Among Patients 30-45 Years Old

AU - Javaid, Aamir

AU - Dardari, Zeina A.

AU - Mitchell, Joshua D.

AU - Whelton, Seamus P.

AU - Dzaye, Omar

AU - Lima, Joao A.C.

AU - Lloyd-Jones, Donald M.

AU - Budoff, Matthew

AU - Nasir, Khurram

AU - Berman, Daniel S.

AU - Rumberger, John

AU - Miedema, Michael D.

AU - Villines, Todd C.

AU - Blaha, Michael J.

PY - 2022/5/17

Y1 - 2022/5/17

N2 - Background: Coronary artery calcium (CAC) is a measure of atherosclerotic burden and is well-validated for risk stratification in middle- to older-aged adults. Few studies have investigated CAC in younger adults, and there is no calculator for determining age-, sex-, and race-based percentiles among individuals aged <45 years. Objectives: The purpose of this study was to determine the probability of CAC >0 and develop age-sex-race percentiles for U.S. adults aged 30-45 years. Methods: We harmonized 3 datasets—CARDIA (Coronary Artery Risk Development in Young Adults), the CAC Consortium, and the Walter Reed Cohort—to study CAC in 19,725 asymptomatic Black and White individuals aged 30-45 years without known atherosclerotic cardiovascular disease. After weighting each cohort equally, the probability of CAC >0 and age-sex-race percentiles of CAC distributions were estimated using nonparametric techniques. Results: The prevalence of CAC >0 was 26% among White males, 16% among Black males, 10% among White females, and 7% among Black females. CAC >0 automatically placed all females at >90th percentile. CAC >0 placed White males at the 90th percentile at age 34 years compared with Black males at age 37 years. An interactive webpage allows one to enter an age, sex, race, and CAC score to obtain the corresponding estimated percentile. Conclusions: In a large cohort of U.S. adults aged 30-45 years without symptomatic atherosclerotic cardiovascular disease, the probability of CAC >0 varied by age, sex, and race. Estimated percentiles may help interpretation of CAC scores among young adults relative to their age-sex-race matched peers and can henceforth be included in CAC score reporting.

AB - Background: Coronary artery calcium (CAC) is a measure of atherosclerotic burden and is well-validated for risk stratification in middle- to older-aged adults. Few studies have investigated CAC in younger adults, and there is no calculator for determining age-, sex-, and race-based percentiles among individuals aged <45 years. Objectives: The purpose of this study was to determine the probability of CAC >0 and develop age-sex-race percentiles for U.S. adults aged 30-45 years. Methods: We harmonized 3 datasets—CARDIA (Coronary Artery Risk Development in Young Adults), the CAC Consortium, and the Walter Reed Cohort—to study CAC in 19,725 asymptomatic Black and White individuals aged 30-45 years without known atherosclerotic cardiovascular disease. After weighting each cohort equally, the probability of CAC >0 and age-sex-race percentiles of CAC distributions were estimated using nonparametric techniques. Results: The prevalence of CAC >0 was 26% among White males, 16% among Black males, 10% among White females, and 7% among Black females. CAC >0 automatically placed all females at >90th percentile. CAC >0 placed White males at the 90th percentile at age 34 years compared with Black males at age 37 years. An interactive webpage allows one to enter an age, sex, race, and CAC score to obtain the corresponding estimated percentile. Conclusions: In a large cohort of U.S. adults aged 30-45 years without symptomatic atherosclerotic cardiovascular disease, the probability of CAC >0 varied by age, sex, and race. Estimated percentiles may help interpretation of CAC scores among young adults relative to their age-sex-race matched peers and can henceforth be included in CAC score reporting.

KW - cardiovascular diseases

KW - cardiovascular risk

KW - coronary artery calcium

KW - coronary artery disease

KW - multidetector computed tomography

KW - percentiles

KW - premature atherosclerosis

KW - primary prevention

KW - young adults

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Distribution of Coronary Artery Calcium by Age, Sex, and Race Among Patients 30-45 Years Old

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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