CAC scan more fruitful for youth with familial hypercholesterolemia or at risk for ASCVD: JACC
USA: A new tool that calculates coronary artery calcium (CAC) percentile scores by age, sex, and race can help clinicians to get a fuller picture of subclinical atherosclerosis in young people aged 30-45 years, claims a recent study. The study appears in the Journal of the American College of Cardiology (JACC).
The researchers showed that the probability of CAC >0 varied by age, sex, and race in a large cohort of US adults aged 30-45 years without symptomatic atherosclerotic cardiovascular disease. CAC scores can be interpreted among young adults relative to their age-sex-race matched peers by using estimated percentiles and henceforth be included in CAC score reporting.
CAC is a measure of atherosclerotic burden and is well-validated for risk stratification in middle- to older-aged adults. However, not many studies have examined CAC in younger adults, and there is no calculator for determining age-, sex-, and race-based percentiles among people aged <45 years.
Considering the above, Aamir Javaid, University of Virginia School of Medicine, Charlottesville, Virginia, USA, and colleagues aimed to determine the probability of CAC >0 and develop age-sex-race percentiles for U.S. adults aged 30-45 years.
For this purpose, the researchers harmonized 3 datasets— Walter Reed Cohort, CARDIA (Coronary Artery Risk Development in Young Adults), and the CAC Consortium to study CAC in 19,725 asymptomatic Black and White individuals aged 30-45 years without known atherosclerotic cardiovascular disease. The probability of CAC >0 and age-sex-race percentiles of CAC distributions was estimated using nonparametric techniques after weighting each cohort equally.
The researchers reported the following findings:
- 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.
The researchers concluded, "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."
Reference:
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. Distribution of Coronary Artery Calcium by Age, Sex, and Race Among Patients 30-45 Years Old. J Am Coll Cardiol. 2022 May 17;79(19):1873-1886. doi: 10.1016/j.jacc.2022.02.051. PMID: 35550683.
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